WOOMB International

Methodology

A recent document prepared by the NFP Secretariat of the Australian Catholic Social Welfare Commission (ACSWC) contains several recommendations related to the service and delivery of service of natural family planning methods. A team of coordinators has been elected who will work closely with both ho and Sympto- Thermal Method groups of NFP teachers. These co-ordinators are mostly teachers of one or other method, and therefore it is desirable that as far as possible, they all should understand the methods of natural family planning other than their own. One of the suggestions made by the Secretariat of the ACSWC was that all teachers should teach all methods and then invite the couples to choose the one they wish to use. This point needs analysis in the light of the history of the methodologies and in the development of the Ovulation Method™ (Billings). The World Health Organization (WHO) attached the name of Billings to the Ovulation Method™ so that its authenticity could be preserved.

These notes have been prepared to explain and emphasize why the Billings Ovulation Method® must be kept separate from other natural methods. It is of importance and benefit to teachers of all methods that the reasons for this separation of methods be clearly understood. It is important to understand that the methods are different and why an indicator does not per se constitute a method. It is important to encourage all teachers to teach that methodology which they are best equipped to teach and with which they are most confident. Most of all it is desired that as teachers of natural family planning, we teach with love, not only the couples who in our society have shown a great need for our help, but also that all teachers should have a loving regard for each other and a respect for the work that we all do.

Choice of NFP Method

Couples coming to a centre to be taught the Billings Ovulation Method® have usually already made a choice in the light of their past experiences. Some have abandoned contraceptive methods, some have found the IVF programme to be a failure, and some have discarded the Sympto-Thermal Method, finding Rhythm calculations and the Basal Body Temperature unsatisfactory, especially in cases of delayed ovulation, for example, breast-feeding, stress, in the years leading up to the menopause and also coming off contraceptive medication when various physiological disorders may be encountered. In some cases, this dissatisfaction had resulted in abstinence for many years as we heard from the couples, with consequent discontent and sometimes serious disturbances in the marriage with frustrations, alcoholism and intentions to resort to surgical solutions for fertility control. There were unhappy children. Couples with no preformed ideas on methodology will logically expect to be advised as to which is the best method by those presumed to be experts. Logically they will be advised according to what the expert believes to be the best. They will not expect to be encouraged to use what is believed to be second best by the experts or to be taught what they, the experts, do not have faith in or are incapable of teaching professionally; as in medical practice, patients, being unknowledgeable, accept the advice of professionals and are not expected to choose their own treatment. This would be considered unprofessional and unethical.

Common Indicators used in Natural Family Planning

The most common indicators used in natural family planning are as follows:

(a) Rhythm calculations.
(b) Cervical mucus response to ovarian hormones.
(c) Basal body temperature (BBT).
(d) Pain.
(e) Vulval swelling.
(f) Bleeding.
(g) Self-examination of the cervix.
(h) Inguinal lymph gland sign.
(i) Vaginal response to ovarian hormones.
(j) Ovarian hormone monitoring, using Professor J. B. Brown’s Ovarian Monitor.

The Billings Ovulation Method® uses:

(i) The cervical mucus response.
(ii) The vaginal response discharge.
(iii) Bleeding.
(iv) Vulval swelling.

Adjuncts are used as indicated, for example BBT, lymph gland sign, ovarian hormone monitoring using the Ovarian Monitor. The way that we finally arrived at the definitive Ovulation Method (Billings Ovulation Method®) was by studying the various indicators individually between 1953 and 1969 and by being determined to get the best out of each one. We were greatly assisted by Professor J. B. Brown’s laboratory work from 1962 onwards, and by Professor E. Odeblad from the mid-70’s.