CALENDAR (RHYTHM) METHOD

The calendar method of contraception, or the rhythm method, works by finding the likely date of ovulation, which is the day an egg is released from the ovary. Extra days are then added, taking into account the uncertainty of the ovulation date and the fact that sperm can live up to five days in a woman's body. During these fertile days, the woman either abstains from intercourse or uses another method of contraception. FINDING YOUR FERTILE DAYS

In order to use the calendar method of contraception effectively, track your cycle for a minimum of four months by circling the first day of each period. The first day of menstrual bleeding (day1 of your period) counts as the first day of the cycle

CALENDAR METHOD USING OGINO-KNAUS FORMULA

A. REGULAR MENSTRUAL CYCLE

A woman who is regular has 28 days menstrual cycle. Approximately 14 days (or 12 to 16 days) before the start of the next period, an egg will be released by one of the ovaries

For example, you have your menstrual bleeding on October 2. You will count your 28 days menstrual cycle from the start of your menstrual bleeding which is October 2. You will notice that your 28 day menstrual cycle will end on October 29 To get the ovulation date, you should count 14 days backward from the end of your menstrual cycle which is October 29). So your ovulation date is on October 16. Abstinence starts 5 days before ovulation and lasts up to 3 days after ovulation. Hence from October 11 until October 19, the couple should avoid coitus because it is unsafe.

B. IRREGULAR MENSTRUAL CYCLE

If the menstrual cycle is highly irregular, 18/11 formula may be used. Count the days for each cycle and pick out the shortest and the longest cycles.

FIRST UNSAFE DAY: Subtract 18 from the total number of days in your shortest cycle (i.e. 28 - 18 = 10 days). Starting with the first day of your next period, count the number of remaining days (10 in this example) and mark an "X" on that day. LAST UNSAFE DAY: Now take the longest cycle and subtract 11 days from the number of days in your longest cycle (i.e. 30 - 11 = 19). Counting the first day of your next period, count the remaining days (19 in this example) and mark an "X" on that day. You should ovulate somewhere in between the days marked with an "X" and will be fertile during that time.

Shortest Cycle: 28 18 = day 10

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

18 DAYS PERIOD Longest Cycle: 30 11 = day 19

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

11DAYS PERIOD UNSAFE PERIOD!! : Day 10 to Day 19 Avoid coitus or use of contraceptives
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

UNSAFE TIME

O = first day of period X = fertile day, abstain or use use contraceptive

ADVANTAGES 1. No prescription required - The rhythm method doesnt require a prescription because couples practice it at home, so itsa method couples always have access to. 2. All Natural - Many couples like the rhythm method because it's an all natural form of birth control and doesn't require taking synthetic hormones or inserting medical devices for pregnancy prevention. 3. Equal Participation - Many couples see the rhythm method as a form of birth control whose responsibility is equally divided between both partners. DIS-ADVANTAGES 1. Lifespan of Sperm Sperm live an average of 3 days in the body, but for some women, sperm can live in their bodies for up to seven days. This makes it difficult to plan when its completely safe to have sex. 2. Reliability - Because each woman's menstrual cycle is different and factors like diet, stress and age can cause a woman's menstrual cycle to change, it can be difficult to determine the exact time a woman is fertile. 3. STDs - The rhythm method doesn't provide any protection against sexually transmitted infections such as HIV, chlamydia or herpes. 4. Most women do not ovulate at the same time every month, and no woman's cycles are identical each time. For this reason, the rhythm method is not very effective unless your cycle is always the same number of days. For women with very regular cycles, the failure rate is probably closer to 13%. This method is completely ineffective if used improperly.

CERVICAL MUCUS MONITORING TEST

Cervical mucus changes are monitored for determining when ovulation occurs through the cervical mucus monitoring test. As your cycle progresses, your cervical mucus increases in volume and changes texture. The changes in the mucus that is secreted from the cervix reflect where you are in your cycle. The consistency of your cervical mucus changes during the cycle due to hormonal fluctuations.

7 WAYS HOW TO CHECK CERVICAL MUCUS

Insert a clean finger in your vagina while you are squatting Swipe around and pull out your finger Check the consistency of the mucus between your fingers If you didnt get a good sample, especially if it feels really wet in there, try again Check your mucus at least once a day After your shower is a convenient time Keep track of your findings on a fertility chart

CERVICAL MUCUS STAGES

BEFORE OVULATION (LOW CHANCE OF PREGNANCY) Right after your period, there wont be much cervical mucus at all. You will feel dryness around your vulva. During this time, chances of getting pregnant are low

INFERTILE CERVICAL MUCUS Starts off filmy, rubbery, sticky Becomes more creamy or lotion Usually has a white coloring

APPROACHING OVULATION (CHANCE OF PREGNANCY) Then around Day 10 (assuming a 28-day cycle, with day 1 being the first day of your period), the cervical mucus will increase and the texture will be thick and very sticky. It is white or cream in color. In the finger test, the mucus will break easily. During this transition time, first the mucus will become cloudy and slightly stretchy during the finger test (this means that it will still break before the fingers are stretched all the way). As time progresses, the mucus will become greater in volume)

TRANSITIONAL CERVICAL MUCUS This creamy cervical mucus is starting to become fertile

RIGHT AROUND OVULATION (HIGH CHANCE OF PREGNANCY) As you get into the days right before ovulation, usually days 1315 for a 28 day cycle, these are the most fertile days. The cervical mucus during your most fertile days is abundant and has the consistency of egg whites, which is to say it will be clear, fairly thin, stretchy, and slippery more than sticky. Finger testing will allow the mucus to stretch quite a ways (several centimeters) before it breaks (if it breaks at all). The amount of thin mucus will steadily increase until you experience your mucus peak. This is the last day of this period where the chance of conception is high. It is closely tied to ovulation. During this phase, the sperms survival rate is higher. It can survive in cervical mucus for 72 hours, a significantly longer time than during the rest of the cycle. AFTER OVULATION (LOW CHANCE OF PREGNANCY After ovulation, there is a marked chance in mucus appearance. It returns to the sticky stage (does not stretch during finger test) and there is again, a feeling of dryness around the vulva.

FERTLE CERVICAL MUCUS Clear or opaque, streaked white flecks Stretchy, slimy, super wet

INFERTILE CERVICAL MUCUS

YOUR MOST FERTILITY DAYS Up to 5 days (or less) before ovulation, your cervix will start producing fertile cervical mucus Sperm can live in fertile cervical mucus for days while they wait for the egg to be released on ovulation day Only intercourse that occurs while you have fertile cervical mucus and on the way of ovulation can potentially result in pregnancy. ADVANTAGES 1. 2. 3. 4. 5. 6. 7. Inexpensive In most women, accurate when done correctly and consistently Teaches you how to read your bodys signals Teaches you how to interpret the texture of the cervical mucus, a fairly precise sign of fertility May work better for women with irregular cycles Can also be used later to prevent pregnancy (by avoiding sex on your most fertile days Monitoring the changes in cervical mucus is the only method that will not require looking back to the past few cycles for analysis, and also provide reliable results that you can trust when trying to conceive. 8. Examining the changes in your cervical mucus can help you pinpoint your time of ovulation and increase your chances of pregnancy. DIS-ADVANTAGES 1. Inconvenient. You must check your cervical mucus everyday 2. Can be messy 3. An unusual event sucha s illness, moving, or a job change can disrupt your cycle, skewing your pattern for the month 4. Doesnt pinpoint exactly when youre about to ovulate. May take two or three months for a pattern to emerge. 5. Sperm can be confused with the mucus secretions and you could make wrong assumptions. 6. vaginal infections, medication, and birth control can alter conditions and should be taken into consideration when examining any vaginal secretions. 7. There are several cases where you may not be able to collect an adequate sample of cervical mucus. 8. Medications, being over 35 years old, & not ovulating can have a dramatic effect on your bodys ability to produce the fertile cervical mucus.

ADRENA CARE ACADEMY of BAGUIO

Baguio College of Technology Baguio City

MATERNITY NURSING (FAMILY PLANNING) October 5, 2012 Baguio City

Submitted to: Mr. Lope Cheng C. Domingo Jr. RN,MAN,EMT Clinical Assessor, NCII

Submitted by: de la Cruz, Catherine C. AB,LLB, HCS Health Care Services