Natural Family Planning

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Recommendations for Contraceptive Use

Natural Family Planning

Classification of Selected Procedures for Natural Family Planning (NFP)

Procedure	Class	Rationale
Pelvic examination (speculum and bimanual)	C	A pelvic exam would only be indicated if a woman were unable to identify the fertile period after several cycles of NFP use. If she complains of abnormal vaginal discharge and wishes to use the CMM, a pelvic exam becomes Class A.
Blood pressure	C	Blood pressure screening is not needed for the safe use of NFP¹.
Breast examination	C	Breast cancer screening is not needed for the safe use of NFP¹.
Sexually transmitted disease (STD) screening by lab tests (for asymptomatic persons)	C	Clients at risk for STDs (by personal history or socio-demographic risk factors) should be offered STD screening where possible.
Cervical cancer screening	C	Cervical cancer screening is not needed for the safe use of NFP¹.
Proper infection prevention procedures	C	Beyond hand washing and personal hygiene, infection prevention procedures are not applicable to NFP use.
Specific counseling points for NFP: instructions for use and teaching points specific to the method signs and symptoms of fertility efficacy importance of partner cooperation STD protection (when/as appropriate)	A	Accurate client education (training and counseling) is essential for couples to learn NFP methods and use them effectively (See Question 7).

KEY:

Class A = essential and mandatory or otherwise important in all circumstances, for safe and effective use of the contraceptive method

Class B = medically/epidemiologically rational in some circumstances to optimize the safe and effective use of the contraceptive method, but may not be appropriate for all clients in all settings

Class C = may be appropriate for good preventive health care, but not materially related to safe and effective use ofthe contraceptive method

Class D = not materially related to either good routine preventive health care or safe and effective use of the contraceptive method

Citations for Procedures Table:

World Health Organization. Improving access to quality care in family planning: medical eligibility criteria for contraceptive use. Geneva: WHO, 1996.

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.

Last Updated: 09 Jul 2003

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