Natural Family Planning

What is natural family planning?

Natural Family Planning Care Guide

  • Natural family planning (NFP) is a way to prevent or to plan a pregnancy. For NFP to be successful, a woman must learn about her monthly menstrual cycle. NFP helps you understand your body's natural signs and symptoms so you can learn when you are most fertile (most likely to get pregnant) each month. There are different NFP methods to help prevent or plan a pregnancy.

  • A couple can use NFP as a contraceptive (kon-trah-SEP-tiv) method to prevent pregnancy. To prevent pregnancy, a couple uses NFP to learn the woman's fertile time. Then they avoid having sexual intercourse (sex) during that time. Other couples use NFP to help them conceive (get pregnant). When trying to get pregnant, a couple uses NFP to learn when the woman's fertile time is. They plan to have sex during that time.

What do I need to know about natural family planning?

  • For natural family planning to work correctly, you will need to learn it well, and do it correctly. You and your partner must be able to work together and have a strong desire to use NFP. You will need to learn about the menstrual cycle, signs of fertility, and using NFP as a contraceptive.

  • NFP should increase the chances of getting pregnant if intercourse is timed with fertile symptoms. On average, it takes about 6 months to get pregnant using NFP.

  • Used correctly, NFP requires abstaining (not having intercourse) for 5 to 7 days a month.

  • Some NFP methods are better than others in preventing or planning pregnancy. The success of NFP in preventing or planning pregnancy also depends on the following:

    • How accurate (correct) the method is in guessing a woman's fertile time each month.

    • How well you and your partner can correctly guess the fertile time.

    • How willing you and your partner are to follow the rules of the NFP method that you are using.

What are the advantages of using natural family planning?

  • There is little or no cost.

  • You and your partner can plan when to have children without using medicines or birth control devices.

  • You and your partner can have sex without using foams, jellies, sponges, condoms, or diaphragms.

  • A woman can avoid the side effects and possible risks of using birth control medicines (such as pills, patches, shots, or implants) and IUDs.

What are the disadvantages of using natural family planning?

  • Body changes and other factors may make it hard to know when you are fertile.

  • If you have irregular monthly periods, the NFP method is not as accurate.

  • This method does not decrease the risk of getting a sexually transmitted disease (STD) while having sex.

  • You may become pregnant when you do not want to.

  • If you do not want to get pregnant, you must use this method correctly. You also must not take chances by having unprotected sex when you may be ovulating.

What is the female reproductive system?

  • A woman's reproductive system includes the uterus and cervix, fallopian tubes, ovaries, and vagina. The uterus is the pear-shaped organ in your abdomen (belly) where a baby grows during pregnancy. It is also called the womb. The cervix is the opening at the bottom of the uterus. The ovaries are two egg-shaped organs on each side of the uterus.

  • The ovaries make and release a female sex cell or egg each month. This is called ovulation. About 10 to 14 days later you will have your monthly period if your egg was not fertilized. The unfertilized egg is then shed during menstruation (monthly period). This means that you are not pregnant. The menstrual cycle is about 28 days long. You have two fallopian tubes. The egg travels from the ovary into a fallopian tube. If there is sperm in the tube from having had sex recently, the egg may be fertilized. If fertilized with sperm, the egg travels down the tube and attaches to the lining of the uterus, called the endometrium. When the egg attaches to the endometrium, it is called implantation.

What are the natural family planning methods?

  • Calendar method: Using this method, a woman's fertile days are found by counting the number of days in your menstrual cycles over the past one or two years. This is also called the "rhythm method". This method may work if the number of days of a woman's menstrual cycle is always the same. If it is always the same, a woman will know when she is ovulating, and can plan to have sex during that time if she wants to get pregnant. If she does not want to get pregnant, she can avoid having sex during ovulation. Because of normal changes in a woman's monthly cycle, the calendar method is not used often.

  • Symptothermal method (STM): This method is also called the combined or mucothermal method. You will need to buy a special basal body thermometer in a drug or grocery store to use the STM.

    • Take your basal body temperature (BBT) before getting out of bed in the morning. Do not talk, smoke, sit, use the bathroom, drink, or eat before taking your BBT. Your basal body temperature drops slightly just before ovulation and reaches its lowest point at ovulation. During the next two or three days, it will increase about one-half to two degrees, before returning to its normal level. After that, your BBT will stay at its normal level for the rest of the menstrual cycle. Write down your BBT on a calendar, or in a record book. If you are trying to get pregnant, you will need to plan to have sex when your body temperature is increased during ovulation. If you are trying to avoid getting pregnant, do not have sex while your body temperature is increased. Avoid drinking alcohol as it may raise your natural BBT. Illness, some medicines, and other factors may also change your natural BBT. If your BBT does not increase during your cycle, it may mean that you did not ovulate.

    • You must also learn how and when to check your cervical mucus (discharge) in order to use STM. Your uterus cleans itself by regularly discharging mucus through the cervix and out your vagina.

      • Cervical mucus that is not fertile is sticky and thick with a cloudy color. The amount of cervical mucus decreases when you are not ovulating.

      • Fertile cervical mucus is clear, watery, stretchy, slippery, and wet like egg whites. The amount of cervical mucus may also increase when you are ovulating. When you have clear and stretchy cervical mucus, you may be ovulating. You may also be ovulating the day before, and the day after your cervical mucus looks this way. If you are trying to get pregnant, plan to have sex during this time. If you are trying to avoid getting pregnant, do not have sex at this time.

    • The following three steps will help you learn more about your cervical mucus.

      • Look at the color and thickness or thinness of your cervical mucus on your panties or fingers. You can also do this by checking the toilet paper.

      • Touch your cervical mucus to feel how stretchy or slippery it is.

      • Feel the wetness of your cervical mucus in the vulva (area between your legs) as you walk.

    • Do not douche when you are checking the cervical mucus. Douching can wash out cervical mucus, which makes it hard to notice changes.

    • Check the position and feel of your cervix to try to learn the start and end of your fertile time. Ask your caregiver or NFP teacher how to check your cervix. Watch for other signs of ovulation, such as lower stomach pain and breast tenderness.

    • If you do not want to get pregnant, use other forms of birth control for three months as you learn about STM. Correctly use contraceptive foam or jelly with condoms or a diaphragm if you want to have sex during these three months. It may take three months or longer to learn your bodies' natural signs and symptoms, and use STM correctly. Using foam or jellies may make it more difficult to notice the normal changes of the cervical mucous.

  • Ovulation Method (OM): To use this method, you will need to check your cervical mucus every day to learn your fertile time. OM may also be called the "Billings Method". Cervical mucus that is not fertile is sticky and thick with a cloudy color. You will have less cervical mucus when you are not ovulating. Fertile cervical mucus is clear, watery, stretchy, slippery, and wet. You will also notice that the amount of cervical mucus increases when you are ovulating. Around the time that you have clear and stretchy cervical mucus, you may be ovulating. If you are trying to get pregnant, you may want to have sex during this time.

  • Lactation Amenorrhea: Breast feeding may keep you from getting pregnant. The hormone prolactin is increased when you breast feed. This hormone stops you from ovulating. The more your baby breast feeds, the more prolactin is released. Because you ovulate before having a period, you may get pregnant while still breast feeding, but before you have a period. It is very important to remember that breast feeding alone is not birth control. If you do not want to get pregnant, use another form of birth control during the period of time that you are breast feeding. You may also use the symptothermal method during this time.

Are there other things that may affect natural family planning?

For most women, their menstrual cycle is different in length each month. Because of this, the calendar method does not work well for NFP. The following may naturally cause your cycles to change month by month:

  • Changes in exercise habits.

  • Diet, such as eating too much processed foods, or too few vegetables.

  • Drinking too much caffeine may also change your monthly cycles. Caffeine may be found in coffee, tea, soda, chocolate, and sports foods and drinks.

  • Emotional changes, such as high levels of stress, depression, and anxiety.

  • Health problems or illness.

  • Increasing age.

  • Stopping birth control pills or other hormonal (medicine) forms of birth control.

  • Weight gain or loss.

Is there a time each month when I am less likely to get pregnant?

You are less likely to get pregnant if you have sex during the non-fertile time of your monthly cycle. The non-fertile time begins on the first day of your monthly period (when the bleeding starts). You may not be fertile again until you notice clear, watery, stretchy, slippery, and wet cervical mucus. When you have mucus that looks like this, you may be ovulating (more fertile). Your BBT may also change at this time. If you are ovulating, do not have sex until your temperature has been increased for three full days, and your mucus has gone back to being sticky and thick with a cloudy color.

Where can I find more information about natural family planning?

Talk to your caregiver about natural family planning. You may also write or call the following for more information.

  • Symptothermal Method:
    • The Couple to Couple League
      P.O. Box 111184
      Cincinnati , OH 45211
      Phone: 1- 513 - 471-2000
      Web Address:
    • Northwest Family Services
      4805 NE Glisan
      Portland , OR 97213
      Phone: 1- 503 - 215-6377
      Web Address:

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about natural family planning. You can then discuss choices with your caregivers. Work with them to decide what choices may be best for you. You always have the right to refuse and make your own decisions.The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.