BILLINGS NATURAL FAMILY-PLANNING IN SHANGHAI, CHINA

With cervical mucus, or Billings, method of family planning, a woman l earns to recognize the characteristics of her cervical mucus that iden tify the fertile phase in her menstrual cycle. She and her partner abs tain from sexual activity during a period from the first indication of mucus until four days after the mucus peak day, which includes ovulat ion. They also abstain during menses, because mucus can be confused wi th menstrual bleeding. This method of family planning is used widely, worldwide, by couples seeking a natural, reliable method of family pla nning. Between July 1988 and May 1990, 688 couples of child-bearing ag e, most of whom were parous, used the Billings method for contraceptio n. Five hundred and fifty of these couples used the method for more th an 12 months. Efficacy, continuation rates, and discontinuation rates were analyzed using life-table analysis for 10 175 woman-months of dat a collected. The net cumulative discontinuation rates per 100 women at 12 and 18 months were 19.85 and 34.58, respectively, resulting in con tinuation rates of 80.15 and 65.42. The discontinuation rates per 100 women for method-related reasons at 12 and 18 months were 1.61 and 2.8 4, respectively, while the discontinuation rates for unintended pregna ncy were 1.02 and 1.18. During the study, 67 subjects volunteered to h ave vaginal smears taken from the upper part of the vaginal wall for c ytologic examinations, and among them serum and urine LH levels were m easured in 10 subjects and urinary estrogen and progesterone were assa yed in 35 cases. These tests related other indications of the menstrua l cycle to the ability of the women to judge ovulation by cervical muc us. Our research suggests that further investigation of the Billings m ethod is warranted and that careful planning and organization are need ed to disseminate the method more broadly.