A recent article in Family Planning(Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope) Perspectives1 reports on contraceptive trends in the United States, by comparing data from the National Survey of Family Growth conducted in 1982, 1988, and 1995. The data sets included women between the ages of 14-44 of all marital status and was obtained by in person face-to-face interviews. The sample sizes were 7,969 in 1982, 8,450 in 1988 and 10,847 in 1995. All three survey years had an 80% response rate.
The most commonly reported method of contraception in the United States by women between the ages of 14-44 in 1995 was sterilization. About 27.7 percent (which represents about 10.7 million women) reported using female sterilization. The second most common method (reported by 26.9 percent of respondents) was oral contraceptives (the Pill). The biggest change in contraceptive use from 1982 to 1995 was the increase in the use of the male condom. Male condom was the third most commonly reported method by 20.4 percent of women(Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope). This is an increase from about 12 percent in 1982. The authors speculated that the increase was stimulated by fear of HIV and STDs.
The proportion of women between the ages of 14 and 44 using some form of contraception increased from 56% in 1982 to 64% in 1995. This means that 36% were not using any form of contraception. The reasons given for not practicing contraception was that 5% were sterile, 9% were currently pregnant, 11% never had intercourse, 6% did not have intercourse in the last three months and 5% had intercourse in the last three months but were not using a method.
All methods of NFP were placed in the category (Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope)of periodic abstinence (PA). PA was used by 3.9 percent of women in 1982, 2.3 in 1988 and 2.3 again in 1995. The 2.3 percent represents about 883 thousand women. There were more women reporting the use of withdrawal (3.0 percent or 1.17 million) and injectable forms (3.0 percent or 1.14 million) than NFP in 1995. Furthermore, about 1% (or about 380,000) women reported the combined use of "calendar rhythm" and the condom and about 1% reported the combined use of "calendar rhythm" and withdrawal. (I find it interesting that the old terms "calendar rhythm" for the use of natural methods was used in the report. In any case, the report indicates that NFP teachers have a lot of work to do to increase the use of NFP in the United States. RJF)
Five Center Study Reveals High Effectiveness of Creighton Model System for Avoiding Pregnancy
A prospective study on the effectiveness of the (Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope)Creighton Model System (rMS) to avoid pregnancy was conducted in five centers, Omaha, St. Louis, Wichita, Houston, and Milwaukee.1 The combined results of these studies were analyzed and reported by Dr. Thomas Hilgers, Director of the Pope Paul VI Reproductive Institute, and Dr. Joseph Stanford from the Department of Family (Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope)and Preventive Medicine at the University of Utah, Salt Lake City. The five studies represent a total of 1,876 couples and 17,130.0 couple months of use. The results were analyzed using life table analysis. The method effectiveness (or perfect use) of the CrMS was 99.5 at the 12th ordinal month and 99.5 at the 18th ordinal month. The use effectiveness results (or typical use) were 96.8 and 96.4 at the 12th and 18th ordinal months. Discontinuation rates were 11.3% at the 12th ordinal month and 12.1% at the 18th ordinal month.
The method effectiveness ratings in the five Creighton Model centers were very stable and effective over time. Use-effectiveness rates on the other hand increased over time(Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope). The first use-effectiveness study conducted in Omaha in 1980 was 94.6% at the 12th ordinal month and the last study in Milwaukee reported in 1995 was 97.9%. The authors attributed the increased use-effectiveness due to improved teaching materials, refined teaching techniques and better NFP teacher training. (A criticism of the study was that the couples in the study over the five centers, were rather similar, i.e., most were Catholic, white, and had at least a high school education. The Creighton system merits continued development and further study of its effectiveness in more diverse populations and with specific reproductive categories. There is also some criticism with regard to how Hilgers and Stanford conceptualize "effectiveness." See, The Journal of Reproductive Medicine 44 (1999) which carries letters from James Trussell and John Kippley as well as a response to them (Family planning (planned parenthood)operation (Surgery,operating,surgical) microscope,Family planning (planned parenthood) microscope)from Hilgers and Stanford. The exchange is very informative and recommended. RJF) 1.......
http://www.usccb.org/issues-and-action/marriage-and-family/natural-family-planning/medical-research/upload/cmr-1999-v10-01-02-winter-spring.pdf