Family Time. Natural Family Planning Knowledge of Effectiveness of Natural Family Planning and Contraceptive Methods Found to Be Poor. Central among the many issues that form a person’s choice in family planning is the method effectiveness rate for pregnancy avoidance (typically, most people do not consider the difference between moral and immoral methods). Despite the fact that couples who have just reasons to avoid pregnancy want a secure method of family planning, they often base their decisions on false perceptions of efficacy per method. Due to this tendency, researchers at Washington University conducted a study to determine the knowledge of contraceptive effectiveness among a cohort of women from Saint Louis.1 The women were enrolled in a project call Contraceptive CHOICE. The project had a larger, more global purpose—to promote the use of long acting reversible contraceptives (LARC), e.g., hormonal implants and intrauterine devices. Once in place in the woman’s body, these contraceptive methods involve little behavioral action. They also have very high “perfect use” and “typical use” effectiveness rates. The researchers enrolled a convenience sample of 5,090 women between the ages of 14-45 years who were willing to start a new reversible contraceptive method. Of these women, 4,144 (81%) completed a baseline contraceptive knowledge effectiveness questionnaire. The main question asked on contraceptive efficacy was: “What percentage (or number of women out of 100) do you think would get pregnant in a year using each method listed below? The available response categories were 10%. The answers were judged based on the contraceptive effectiveness results determined by James Trussell (Princeton University) and widely published in journals and books on contraception.2 The researchers found that the perceived contraceptive effectiveness of sterilization, the IUD, and contraceptive implants were incorrect among 76%, 65%, and 55% of respondents, respectively. Most participants overestimated the effectiveness for condoms, the hormonal birth control pill, and Natural Family Planning (NFP). Only 50% identified the correct typical effectiveness rate of NFP and only 33% identified the effectiveness rate of condoms. The author recognized the limitations of the study indicating that the participants were selected by convenience (i.e., mostly poor and minority women) and were biased in that health professionals promoted use of LARC methods with this group of women. They concluded that there is a gap in knowledge about contraceptive methods and encouraged contraceptive counseling. Comments The researchers raise concern about deceptive advertising practices among manufacturers of hormonal birth control pills who often provide only perfect use pregnancy rates and neglect typical use rates. The researchers suggest that providing typical use effectiveness rates would be more honest for the consumer. This advice is also useful for those promoting NFP methods. NFP 3 promoters and teachers should provide both perfect use and typical use pregnancy rates in all educational materials as well as in instruction. In addition, NFP promoters and teachers should also provide comparative differences in the efficacy of the various methods of NFP when available.
Posted on: Fri, 08 Nov 2013 09:36:49 +0000