Bill & Melinda Gates Foundation

Keeping an Open Mind: What the Evidence Tells Us About the Standard Days Method

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February 19, 2013

“Over 200 million women and girls in developing countries who want to delay, space or avoid becoming pregnant are not using effective methods of contraception.”

Although access to services and costs of contraceptives are obstacles for many women, the major reasons women give for non-use are the fear of side effects and complications, infrequent sex, and opposition.

There is, however, an effective natural method which could help address this contraceptive gap. The Standard Days Method® of family planning is a well-researched fertility awareness-based method positioned to address the top reasons women state for not using contraception.

What is a “fertility awareness-based method” exactly? The Standard Days Method works by…

Many people assume natural methods are ineffective, usually citing anecdotal evidence. However, the Standard Days Method was shown to be more than 95 percent effective with correct use and 88 percent effective with typical use, comparable to other user-controlled methods like pills and condoms. This method has already been included in the World Health Organization’s family planning cornerstone documents and in the national family planning norms of many countries.

While establishing a method’s efficacy is fundamental, a larger question remains. Will women use this method?

Data from numerous studies (Nigeria, Ethiopia, Kenya, Turkey, Worldwide) indicate that many women across various geographies, education and socioeconomic levels want to use the Standard Days Method, and they are able to use it correctly and consistently to avoid pregnancy. Their experience suggests the Standard Days Method is empowering for many women. They report that gaining knowledge about their bodies and menstrual cycles has increased their self-confidence and their ability to care for their health.

The Standard Days Method involves men in family planning and may improve condom use as well. Studies in multiple countries have demonstrated men’s interest; through purchasing condoms for use during the fertile days and helping their wives keep track of their cycles, men are true partners in using the method. Both men and women who choose this option show high levels of satisfaction with the method and report that communication between the couple improved when they began using it.

Some reproductive health professionals are skeptical. They are concerned that the method will siphon off users of other modern methods of contraception. This concern is unfounded. The majority of people who have adopted the Standard Days Method have never used modern methods before, ranging from 60 percent in Peru to 95 percent in Rwanda. A minority had dropped out of using other modern methods due to side effects and the Standard Days Method brought them back.   

In fact, adding the Standard Days Method to the method mix, improves overall use of modern methods of family planning.  The Standard Days Method often serves as an introduction to a wide range of other contraceptive options. For example, when the method was introduced in rural India, the percent of women using modern contraception rose over a four-year period from 24 percent to 41percent, with 7 percent of women using the Standard Days Method.

The Standard Days Method is attractive for both non-religious and religious reasons. While the majority of women who use the Standard Days Method throughout the world do not choose it primarily based on religious reasons, faith-based and community organizations find that it is a culturally appropriate way to introduce and discuss the healthy timing and spacing of pregnancies.  This paves the way for bringing new partners to the family planning field and transforming community norms about family planning, even in conservative settings.

The Standard Days Method is another choice in a basket of effective options for women and couples who wish to avoid pregnancy; particular advantages include its low cost and lack of side effects.


Learn more about the Standard Days Method at www.irh.org or www.k4health.org/toolkits/sdm

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