2003 Science & Research Forum

Biosketch:

Minna Nikula, MD, MPH, is a Medical Doctor with a Public Health degree in Population and Family Health Science. She has both clinical and program experience in reproductive health, particularly in family planning in developing countries. She is currently working as a senior research officer in the Institute for Reproductive Health in Georgetown University, where she is responsible for monitoring the field trials and providing technical assistance to the Institute’s research projects.

Presentation Abstract:

The Efficacy Trial of the TwoDay Method: Preliminary Results

The TwoDay method of family planning is based on identifying the fertile days of a woman’s menstrual cycle by feeling and observing the presence or absence of cervical secretions . The efficacy of this method, developed by the Institute for Reproductive Health at Georgetown University, is currently being tested in a multi-center trial in Guatemala, Peru and the Philippines.

Community health workers and midwifes offered and taught the method to 450 women who chose to participate in the study. These clients have been marking daily information on the presence and absence of their cervical secretions, bleeding and intercourse. The study has collected data from about 3000 cycles and is expected to provide information from over 4000 cycles by August 2003 when the last clients will have completed their 13th cycle of method use.

Women with different age, ethnicity and level of education, most of whom had previously noticed cervical secretions, have easily learned to use the method. However, the preliminary information suggests that the identification of the onset of sections as well as the couple commitment to abstain on the fertile days are the most challenging issues in the correct use of the TwoDay method. The Institute is currently conducting qualitative studies to obtain more detailed information on these issues to be able to provide more accurate counseling and teaching materials for future use of the TwoDay method.

The TwoDay Algorithm: If a woman notices any secretions today or yesterday, she is probably fertile.

Commentary:

This multi-center trial looks at the efficacy and challenges of teaching another very simple method of natural family planning in three third world countries. The size of the study is good (450 women and 4000 cycles). There are several teaching and behavioral issues that are raised, some of which all natural family teachers have to deal with: appropriate observations by the couple, and the couples' knowledge and use of achieving or avoiding behavior.