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31 Issues L. & Med. 205 (2016)
Behavioral Methods of Family Planning: A Comparative Study of Efficacy and Safety of Fertility Awareness Based Methods and Birth Control Pills

handle is hein.journals/ilmed31 and id is 213 raw text is: Behavioral Methods of Family Planning: A Comparative Study of Efficacy and Safety of Fertility Awareness Based Methods and Birth Control Pills Ana Maria Dumitru* Marguerite Duane, M.D., M.H.A.** Background and Purpose Published reports indicate that over 100 million women worldwide use the birth con- trol pill (Oral Contraceptives, or OCPs).1'2 However, in a national study conducted by the Battelle Centers for Public Health Research and Evaluation, rates of discontinuation of some birth control methods were as high as 90%, and had averages between 40-61% (depending on marital status) for women who were followed over a two-year period.3 This suggests that women are searching for new methods, perhaps with fewer side effects or better effectiveness rates. Studies show up to 60% of women would be interested in using Fertility Awareness Based Methods (FABMs) if given information.' Both FABMs and OCPs entail behavior modification on a daily basis, so the efficacy and side effects of FABMs and OCPs were chosen for comparison during this study Most commonly reported unintended pregnancy rates for FABMs and OCPs are based on low quality retrospective surveys. A popularly cited review from J. R. Trussell and colleagues reports typical use failure rates of 24% for FABMs and 9% for OCPs.5 These numbers are based on estimates of the probability of pregnancy drawn from the 1995 and 2002 National Surveys of Family Growth.', There are at least three major problems with these surveys. One is that these are lower quality retrospective surveys based primarily on patient recall, with the data collected via a series of phone surveys. Another major problem is that 86% of the purported FABM users surveyed identified the calendar rhythm method-a much older and less effective method-as their prima- * Dartmouth Geisel School of Medicine. ** Georgetown University, Fertility Awareness Collaborative to Teach the Science. 205

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