Recommendations for Contraceptive Use
		Natural Family Planning

Recommendations	Rationale
a) No medical side effects are associated with the use of NFP.	a) No drugs or devices are used with NFP. Fertility awareness-based methods produce no medical side effects. However, periodic abstinence and fear of unplanned pregnancy may create tension and psychological stress in some couples. Hatcher RA, Trussell J, Stewart F, Stewart GK, Kowal D, Guest F, et al. Fertility Awareness. In: Contraceptive Technology. New York: Irvington Publishers, 1994:327-40.
b) The best evidence indicates that there is no increased risk to the fetus associated with the use of NFP.	b) Recent studies show that there is no increased risk of spontaneous abortion, small birth size, low birth weight, or malformation to fetuses among users of NFP. Gray R, Simpson J, Kambic R. Timing of conception and the risk of spontaneous abortion among pregnancies occurring during the use of natural family planning. American Journal of Obstetrics and Gynecology 1995;172(5):1567-72. Castilla E, Simpson J, Queenan J. Downs syndrome is not increased in offspring of natural family planning users (case control analysis). American Journal of Medical Genetics 1995; 59(4):525.

Any part of Recommendations for Updating Selected Practices in Contraceptive Use may be reproduced or adapted to meet local needs without prior permission from the TG/CWG Secretariat, provided the TG/CWG is acknowledged and the material is made available free of charge or at cost.