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???

2 comments:

bluemirror said...

I'm appalled. Seriously. Like you said, when it's possible to read your body and get an accurate picture, why on earth would you promote rhythm'n'blues?

As of 2002, out of 15-44 yo's who'd had intercourse:

Rhythm method - 0.7% using it, 16.2% tried it
NFP - 0.2% using it, 3.5% tried it

That shocked me. Source of data:
http://www.cdc.gov/nchs/about/major/nsfg/abclist_r.htm#rhythm
http://www.cdc.gov/nchs/about/major/nsfg/abclist_n.htm#natural

If they're going to give a grant, can't they put it into research to develop the good methods we have, rather than promoting calendar method? For example, what if there's another really obvious sign we still haven't discovered, like the temperature rise?

T said...

I love the fertility awareness method! It tells me so much about my body and what it's doing in real time. I nurse, and I have even managed to use sensitive nipples as an ovulatory sign in addition to the other 3! I have learned that I get oily skin and often break out when my cervical fluid is creamy or egg-white. It makes me think of the beauty, unity and best-ness (that's not a word, is it?) of nature. To think women are stupid and incapable of learning the method appropriately is insulting.

But, there are some women who don't want to have to learn the method or use a condom or a pill. Cycle beads, for the 26-to-32-dayers, are a brainless alternative. Or, as my sister's midwife who uses cycle beads said, it's a good method if you don't mind an oops.

If you mind an oops like most of us, FAM is the way to go.

About the grant, part of me wonders if it's their way of keeping people in the dark about FAM and viewing natural methods as less than adequate.