"A lot of my patients use other (birth control) methods during the fertile time, because the reality is that at the time women most want to have sex — it's difficult to abstain because of the surge in hormones," Ryan says. "It's a biological urge to create babies, and that's the flaw in the thinking of those who advocate abstinence during the fertile time."
Abstinence, it appears, is the Achilles' heel of natural birth control. Contraceptive Technology, a manual for health care providers, says that in "perfect use," natural methods are 91 percent to 99 percent effective — as effective as the pill. But in the real, nonperfect world, natural methods are only 75 percent effective. Most people who teach natural family planning say that reflects the challenge of abstaining from intercourse during risky times.
Ryan says a number of her natural family planning patients have become pregnant, but almost always because the couple ignored signs that the woman was ovulating. McCaslin says the FertilityCare Center sees between five and 10 unplanned pregnancies out of 200 new users each year, but "very rarely do we find one that doesn't have an explanation as to why it occurred."
Mary Cullinane, a nurse practitioner and director of patient services at Planned Parenthood of the Texas Capital Region, says the majority of Planned Parenthood patients who use fertility awareness are educated, interested in natural health, and are in stable relationships with a partner who is willing to abstain. But, she says, she can count on one hand the number of these women she sees in a year.
"Any method that requires a lot of user thought and preparedness, or cooperation from the partner, is going to be less effective than the methods where you don't have to do anything — where you just take a pill every day, or you put an IUD in and it lasts for years, or you get implants in your arm. It takes a lot of motivation, education and cooperation, and not everybody has that in their relationship or their life," she says. (emphasis added)
I foresee new ads:
The Pill! Perfect for the couple who can't be bothered to communicate!
Less talk, more sex! A condom a day keeps discussion at bay!
Give yourself an IOU on committment! Use an IUD!
Or maybe not...