Session Two

ReviewCervical signsSecondary signsAchieving and identifying pregnancySympto-Thermal Rule6-5-0 Day RuleEffectiveness

Possibly Fertile Time

Possibly Fertile Time

Let Your Cervix SHOW You When You Are Fertile

Charting the Cervix

F F S S S S S S S SEWEWEWEW L L L H H H H L L L

Ø M M M M M M M M M Ø M M M C C O O O O O O C C

F F S S S S S S S S F F F F Ø Ø M EW EW EW EW M M Ø

M M M M

1" 1" 1½" 2" 1" 1" 1½" 2"

T T T T T T

F = firm S = soft

L = low H = high

C = closed O = open

Ø = dry M or EW-M = wet

Charting the Cervical Mucus at the Cervix

Client I.D. #: _______________ Name: _____________________ D.O.B.: ________ Gyn. Age: 22 Notes: ______

Children #M: 2 #F: 0 Miscarriage: 1 Temp. Method: Oral Time: 7:00 a.m. Cycle Range: 27-33 This Cycle: 29 Cycle#: 2

Month 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Day 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Menses

37.2 99.0 PK GC

.1 .8

37.0 .6

.9 .4 Sensation d d d L L d d d d

.8 .2 EWEWEWEW

.7 98.0 Tissue Ø Ø Ø M M M M M M M M

.6 .8 P P 1" 2" 2" G Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø M36.5 .6 OT T

.4 .4

.3 .2

.2 97.0 Cervix FL FL FL FL SH SH SH SH SH SH FL FL FL FL FL FL FL FL FL FL FL FL FL FL

.1 .8 C C C C O O O O O O C C C C C C C C C C C C C C

36.0 .6 Ø Ø Ø Ø M EW EW EW EW M Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø

.9 .4 M M M M ¼"

.8 .2 1" 1" T 1" T 1" T

°C °F

Do Activities #5a and #5b

• After reviewing the tissue examination and the sensation observation, turn to pages 10-12 and complete the activities.

Secondary Signs

Client I.D. #: ________________ Name: _________________ D.O.B.: _____ Gyn. Age: 22 Notes: __

Children #M: 2 #F: 0 Miscarriage: 1 Temp. Method: Oral Time: 7:00 a.m. Cycle Range: 27-33 This Cycle: 29 Cycle#: 2

Month 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Day 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Menses

37.2 99.0 PK GC

.1 .8

37.0 .6

.9 .4 Sensation d d d L L d d d d

.8 .2 EW EW EW EW

.7 98.0 Tissue Ø Ø Ø M M M M M M M M

.6 .8 P P 1" 2" 2" G Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø M36.5 .6 OT T

.4 .4

.3 .2

.2 97.0 Cervix

°C °F

IP = Intermenstrual Pain

BT = Breast Tenderness

IP BT BT BT

Achieving Pregnancy

Gyn Age: 20 M: 0 F: 0 MC: 0Cycle #: 5 Range: 22-36 Temp: Vaginal Time: 6:30 a.m.

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Menses PK

37.2 99.0

.1 .8

37.0 .6

.9 .4

.8 .2 EW EW EW

.7 98.0 Ø Ø Ø Ø M M M M M M Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø

.6 .8

36.5 .6

.4 .4

.3 .2

36.2 97.0

°C °F

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

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Identifying Pregnancy

Children M: 0 F: 1 Miscarriage: 0 Method: Vaginal Time: 7:30 a.m. Cycle Range: 27-33 Cycle#: 20 Gyn. Age: 23

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39

Menses PK BT BT BT BT BT

37.2 99.0 GC

.1 .8

37.0 .6

.9 .4 Sensation d d d d d L L L d d d d d d d d d d d d d d d d d d

.8 .2 EW EW EW EW Ø Ø Ø Ø Ø Ø Ø Ø

.7 98.0 Tissue Ø Ø Ø Ø Ø M M M M M M Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø

.6 .8

36.5 .6 P R B

.4 .4

.3 .2

.2 97.0 Cervix F F F F F S S S S S S F F F F F F F F F F F F F F F F F F F F F F F

.1 .8 L L L L L L L H H H H L L L L L L L L L L L L L L L L L L L L L L L

36.0 .6 C C C C C C O O O O O C C C C C C C C C C C C C C C C C C C C C C C

.9 .4 Ø Ø Ø Ø Ø M M EWEWEWEW Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø

.8 .2 M M M M

°C °F 5:30 AM Temp1" T

1" T

1" T

1" T

.. . .

Implantation Process

Unborn Child

Unborn child at 14 weeks

EW EW EW

M M M M M M M Ø Ø

PK

Let’s Say Peak Day Is Here…

The Temperature Pattern May Look Like This:

Watch for 3 Temperatures in a Row…

All higher than immediately preceding 6…

65

43

2

1

To separate the “initial” highs from the “final” lows

65

43

2

1

Draw a Pre-Rise Baseline through the highest of the final 6 lows

65

43

2

1

PRB

2

5 16 3

4

Full Thermal Shift Level is 0.4°F above the PRB

PRB

FTSL

.4°F

*FTSL = 0.36° F/0.2° C

EW EW EW

M M M M M M M Ø Ø

PK

6

5

4

3

2

1

PRB

FTSL

.4° F

CITCIT starts the evening of the 3rd post-peak high in a row, if it is on or

above the FTSL.

If the 3rd post-peak high is not on or above the FTSL, wait until the evening of the 4th post-peak

high to assume the CIT.CIT.

PK

EW EW EW

M M M M M M M Ø Ø

.4°F

6 5 3

4 1

2

PRB

FTSL

Completely Infertile Time

Completely Infertile

Time

6-5-0 Day Rule

HIGH TEMPERATURE (1-2 WEEKS)

1 2 3 4 5 6Infertile Days

6-5-0 Day Rule

Client I.D. #: __________________ Name: __________________________ D.O.B. ________ Gyn. Age: 22 Notes: _____

Children #M: 2 #F: 0 Miscarriage: 1 Temp. Method: Oral Time: 7:00 a.m. Cycle Range: 27-33 This Cycle: 29 Cycle#: 2

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 25 26 27 28 29 1 2 3 4 5 6

Menses IP BT BT BT

37.2 99.0 PK GC

.1 .8

37.0 .6

.9 .4 Sensation d d d L L d d d d Sensation d

.8 .2 EWEWEWEW

.7 98.0 Tissue Ø Ø Ø M M M M M M M M Tissue Ø

.6 .8 P P 1" 2" 2" G Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø M36.5 .6 OT T

.4 .4 6 3 2 1

.3 .2 5 4

.2 97.0 Cervix FL FL FL FL SH SH SH SH SH SH FL FL FL FL FL FL FL FL FL FL FL FL FL Cervix FL

.1 .8 C C C C O O O O O O C C C C C C C C C C C C C C

36.0 .6 Ø Ø Ø Ø M EW EW EW EW M Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø

.9 .4 M M M M ¼"

°C °F 1" 1" T 1" T 1" T

.

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6-5-0 Day Rule Application

Shortest Past Cycle Assume Infertile• 26 days or longer 6 days• 23-25 days 5 days• 22 days or less 0 days (for now)

What Do You Think?

Cycle Range: 27-36

Cycle Day 1 2 3 4 5 6 7 8 9 10 11

Menses

37.2 99.0

.1 .8

37.0 .6

.9 .4 Sensation d a.m.

.8 .2

.7 98.0 Tissue Ø a.m.

.6 .8

36.5 .6

.4 .4

.3 .2

.2 97.0

Cervix SO

°C °F (Usually FC after menses)

Do Activity #6

• With this activity you will be applying both the 6-5-0 Day Rule and the Sympto-Thermal Rule. Pay attention to the cycle length as well as the charting data.

• Indicate the beginning and end of the fertile time with the use of “wavy” lines.

• Mark the Peak Day, 6 low temperatures, the PRB, Full Thermal Shift Line (.4oF), and the necessary encircled high temperatures.

Range of Ovulation

Client I.D. #: _________________ Name: ______________________ D.O.B.: ________ Gyn. Age: 13 Notes: ______

Children #: 0 Temp. Method: Oral Time: 6:30 a.m. Cycle Range: 27-36 This Cycle: _________ Cycle#: 38

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Menses

37.2 99.0

.1 .8 3 2 1 PK 1 2 3

37.0 .6

.9 .4 Sensation

.8 .2 EW EW EW EW

.7 98.0 Tissue Ø Ø Ø M M M M M M M M Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø M

.6 .8 Ø Ø36.5 .6

.4 .4

.3 .2

.2 97.0 Cervix

°C °F

..

Surprise Pregnancy?

Client I.D. #: ______________ Name: _________________________________ D.O.B.: ________ Gyn. Age: 23 Notes: ______ Year: ______

Children #M: 0 #F: 3 Miscarriage: ____ Temp. Method: Rectal Time: 7:00 a.m. Cycle Range: 27-32 Cycle#: 8

Cycle Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39

Menses PG37.2 99.0 X X X

.1 .8 Sensation

37.0 .6 EW EW

.9 .4 Tissue Ø ? M M M M •

.8 .2

.7 98.0

.6 .8

36.5 .6

.4 .4

.3 .2

36.2 97.0

°C °F Cervix

Reasons for Using NFP

Philosophical/Religious

Moral/EthicalPsychology

Biological

Definitions

• Method Effectiveness – Rules are correctly understood and followed

• Use Effectiveness– Actual use including misunderstanding and

carelessness

NFP Effectiveness

• Method Effectiveness – 97-99+ percent

• Use Effectiveness – 90-99+ percent

Factors that Affect Use of Family Planning Methods

• Family planning intention– limiting, spacing, achieving

• Marital status• Age• Education

Use Effectiveness of NFP Depends Upon…

• Course of instruction with follow-up

• Consistent and correct charting

• Knowing and following the rules especially complete abstinence from all genital contact

Family Decision