NFP Methods

Natural Family Planning is an umbrella term for a variety of methods of identifying the fertile and infertile days that occur cyclically for a woman. With this knowledge, couples can effectively plan their families, limiting intercourse to infertile days when it is their intention to avoid pregnancy, including fertile days when it is not necessary to avoid a pregnancy, and focusing on fertile days should they experience difficulty achieving pregnancy. The dynamic that is basic to all modern methods is that the woman observes the signs her body produces, and the couple tracks the information using a charting system, mutually deciding if the day is fertile or infertile, and responding appropriately consistent with their intention and the guidelines of the method. The chart also serves as an important tool in the woman’s healthcare, providing a specific individualized record of her hormonal fluctuations, invaluable in the evaluation and treatment of a variety of women’s health issues.

Outdated NFP methods relied on a history of cycles, were practical only in women with fairly regular cycles, and depended on a mathematical calculations of the probability of a day being fertile based on where she is in her cycle or where she might have ovulated in previous cycles.  The Rhythm Method, as it was called, was state of the art for its time, reflecting the medical understanding of the era, but as scientific knowledge advanced, modern NFP methods rendered it obsolete in the 1960’s.

Modern NFP is prospective in nature, basing decisions not on past history, but on what is happening now, today, and therefore is effective for any woman, whether regular or irregular, or even if not in cycles, such as a during breastfeeding. Modern NFP methods can be categorized under two main types: 1) Ovulation Methods, which rely on the observation of the primary indicator of fertility, the changes in the cervical mucus that is discharged when estrogen levels rise as the woman becomes fertile and nears ovulation, and 2) Sympto-Thermal Methods, which in addition include the observation and tracking of secondary symptoms of fertility, such as temperature changes, breast tenderness, cervical position, etc.

1) Ovulation Methods are based on the woman observing the presence or absence of cervical mucus, obvious to her by external observation. The main methodologies providing services in California are the Billings Method, the Creighton Model FertilityCare System, and the Family of the Americas. They are all based on observing the changes in the cervical mucus, but vary in how they teach the woman to observe for and interpret these changes, the instructional process, and their teacher training programs.

2) Sympto-Thermal Methods include observation of cervical mucus, but also usually incorporate daily readings of the woman’s basal body temperature. A sustained rise in her temperature confirms she is postovulatory. She also will be taught to observe secondary signs of fertility such as the position of the cervix and breast tenderness. The main Sympto-Thermal Method Programs are provided by the Couple to Couple League and SymptoPro. Both programs educate the woman/couple in the full range of symptoms, emphasizing cervical mucus and temperature, but differ in how their educational process, and charting systems, as well is in their teacher training requirements.


3) Sympto-Hormonal Method is a term used to describe methods like the Marquette Model, developed at Marquette University, which uses a monitor to measure hormones secreted in the urine.

NFP Professionals throughout California offer the Billings Method, Creighton Model FertilityCare System, Family of the Americas, Couple to Couple League, and SymptoPro Methods.The variety of methods available permit couples to choose the method that suits their personal preference. Factors which influence this preference might include convenience of classes, or their preference for group or individualized instruction, in addition to the methodological differences. For those who do not have local services in their preferred method, most teachers offer long distance instruction.