Natural Family Planning, Part II

A bit more about the Natural Family Planning (NFP) group of birth control methods mentioned in my last NFP post.

What are the NFP methods?

1. CONTINUOUS ABSTINENCE

2. OUTERCOURSE

3. COITAL TECHNIQUE

4. FERTILITY AWARENESS METHODS (FAM)

5. LACTATIONAL AMENORRHEA (Breastfeeding)

How do NFP methods work?

The methods in this group work by relying on sexual techniques (continuous abstinence, outercourse, and coital technique), fertility indicators (fertility awareness methods), or breastfeeding (lactational amenorrhea) to prevent pregnancy.

The sexual technique methods prevent insemination (the deposition of sperm in or near the vagina). The man avoids ejaculation, or ejaculation in or near the vagina.

The fertility awareness methods prevent insemination (or fertilization). First, you identify the fertile period of the monthly cycle with the aid of fertility indicators. Second, you either abstain from sexual intercourse (periodical abstinence) or you use a back-up method during that period of time.

The lactational amenorrhea method prevents ovulation by taking advantage of the hormonal changes that happen during breastfeeding.

In this post, let's take a closer look at the sexual technique methods.

Review of sexual technique methods.

• Continuous Abstinence

This birth control method relies on sexual behavior to avoid pregnancy. It involves complete and continuous abstinence from any form of sexual activity. Obviously, since no sexual activity occurs, insemination is prevented.

The 1st year failure rate is 0% with perfect use. The typical-use rate is unknown.

• Outercourse

This birth control method also relies on sexual behavior to avoid pregnancy. It involves complete avoidance of vaginal-penile intercourse and engaging only in other types of sexual activity (mutual masturbation, oral intercourse, frottage [body rubbing], etc.). Because ejaculation does not occur in or near the vaginal area, insemination is prevented.

There are no published studies on this method's efficacy.

• Coital Techniques

The methods in this group rely on correctly performing a sexual technique to avoid pregnancy.

Coitus Interruptus (CI)

"Interrupted" vaginal-penile intercourse is the main method in this group. Other names used for this method: withdrawal or "pulling out". CI requires the man to withdraw his erect penis from the vagina just before he is about to ejaculate (climax). He then ejaculates outside of the vagina (ideally, as far away from the woman's external genital area as possible). Because sperm is not released in or near the vagina insemination is prevented.

The 1st year failure rate is 4% with perfect use, and 27% with typical use.

Coitus Reservatus (Coitus Prolongatus)

"Reserved" or "prolonged" intercourse requires the man to consciously try to refrain from ejaculating altogether. The penis is maintained erect in the vagina for the duration without ever ejaculating. The act of intercourse ends with the spontaneous or induced flaccidity of the penis (loss of erection), without ejaculation ever taking place at all, inside or outside the vagina.

This is in contrast to CI (withdrawal) where the erect penis is withdrawn from the vagina and ejaculation does take place, away from the vaginal area.

Coitus Obstructus

"Obstructed" intercourse is a sexual technique in which the flow of the ejaculate is directed inward (inside the man's body) rather then outward (in or near the woman's vaginal area). Right before ejaculation, either the man or the woman obstructs the flow of semen through the urethra (by squeezing the base of the penis, or by firmly pressing the area between the scrotum and the anus [perineum]). This forces the semen from the ejaculate to flow back and enter the man's urinary bladder (where it is destroyed and excreted in urine).

Next installment: Fertility Awareness Methods.