Pregnant pause

Lockdown has seriously hit family planning services and menstrual health supplies resulting in unintentional pregnancies, writes Dr Nirmala Chandrashekhar

While Covid-19 has affected the lives of millions due to lockdown restrictions and social distancing, some women are getting affected due to unintentional/unplanned pregnancies and other complications that are arising from it. Natural family planning methods are the best effective methods to adapt during such times.

Standard days method

This method can be adapted by women whose cycles are usually between 26 and 32 days. It identifies a fixed fertile window in a woman’s menstrual cycle when pregnancy is most likely.

Days 1-7 of a woman’s menstrual cycle are considered infertile.

Days 8-19 are considered fertile; considered unsafe for unprotected intercourse.

Day 20 and through the end of the cycle are considered infertile.

Rhythm method (Knaus–Ogino method)

In this method, the first day of bleeding is considered day one of the menstrual cycle. The ovulation occurs around the 14th day in a 28-day menstrual cycle.

To find the estimated length of the pre-ovulatory infertile phase, 19 days are subtracted from the length of the woman’s shortest cycle. To find the estimated start of the post-ovulatory infertile phase, 10 days are subtracted from the length of the woman’s longest cycle.

When used to avoid pregnancy, the rhythm method has a perfect-use failure rate of up to 9% per year. However, the length of the pre-ovulatory phase can vary significantly, depending on the woman’s typical cycle length, stress factors, medication, illness, menopause, breastfeeding, and whether she is just coming off hormonal contraception.

If a woman with previously regular cycles has a delayed ovulation due to one of these factors, she will still be fertile when the method tells her she is in the post-ovulatory infertile phase.

(The author is a consultant obstetrics,
gynaecology & gynaec oncology)