By Amaryllis Sánchez Wohlever, MD (with guest author, Luis Garcia, MD)
February 20, 2018

As physicians, we learn the importance of “informed consent” early on. Using the latest evidence-based information, we educate men and women daily and help support them to make informed decisions about their health. As educators and healthcare professionals, we have a tremendous responsibility to provide accurate information that leads to the best possible choices to meet each person’s unique needs. Such thorough communication and trustworthy guidance can change the course of someone’s life.

  In December, family physician and FACTS trained speaker Dr. Luis Garcia, published such up-to-date information in “Fresh Perspectives”, a news site of the American Academy of Family Physicians. We invite you to share this information with other healthcare professionals so we can continue to dispel myths about modern fertility awareness based methods (FABMs) and educate our colleagues. This will enable more women and couples to make truly informed choices for their health while also meeting their family planning needs.

Below is an excerpt from Dr. Garcia’s article, followed by a link to the full article.

“There have been claims that FABMs carry a 24 percent failure rate in preventing pregnancy. This figure would seem to be a daunting condemnation of these methods, but this is a grossly misleading statistic, and it’s not accurate to equate fertility awareness methods with the rhythm method.

“The 24 percent failure rate stems from data pulled from the National Survey of Family Growth (NSFG) conducted in 1995 and the NSFG survey performed in 2002, which were then summarized in a 2011 study.[i] In those surveys, women who became pregnant in a 12-month period were asked what method of birth control they were using when they became pregnant. Any answers that included “rhythm,” “calendar,” “mucus” or “temperature” methods, “periodic abstinence” or “natural family planning” were combined, and the resulting data led to the conclusion that women who used these methods had approximately a 24 percent unintended pregnancy rate.

“The trouble is, the overwhelming majority of FABM users in the study said their primary form of contraception was the calendar rhythm method, which does not accurately represent modern FABMs.

“Thankfully, in the past few years, many organizations, including Planned Parenthood and the American College of Obstetricians and Gynecologists have begun to distinguish between the different types of FABMs and provide more up-to-date data on efficacy. In one of the best studies to date, the authors looked at all the research about efficacy rates available for each method published since 1980 and ranked the level of evidence based on Strength of Recommendation Taxonomy criteria.[ii] In 2012, American Family Physician published a review of the methods, which shows 92 to 98 percent efficacy in avoiding pregnancy with typical use for some of them. When compared with other methods that require a behavioral change, such as birth control pills or condoms, the evidence shows that FABMs are just as effective, and in some cases, more effective.”

Read Dr. Garcia’s full article here.

References
[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638209/

[ii] https://www.factsaboutfertility.org/wp-content/uploads/2013/07/2013-Manhart-et-al-Review-of-Effectiveness-Osteopathic-Family-Plysician.pdf

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