Effectiveness of a standard-rule method of calendar rhythm among Mayan couples in Guatemala

Context: Mayan couples in Guatemala have very low rates of contraceptive us e but have long expressed an interest in natural family planning methods. Methods: A simple calendar rhythm method of family planning was tested amon g 301 couples living in two departments in the Guatemalan highlands. The me thod requires couples to keep track of the woman's menstrual cycle, using a calendar and a necklace as a reminder, and to abstain from intercourse on days 9-19 of each cycle. Participants-most of whom were Mayan, had had fewe r than seven years of schooling and had never used a contraceptive method-r eceived instruction in how to use the method and were followed up for one y ear. Data were analyzed using life tables. Results: Seventy-nine percent of couples successfully completed one year of use. Any difficulties they encountered with the method (i.e., with using t he calendar or necklace, or abstaining from intercourse for I I days each m onth) occurred early in the study and after one year, couples were highly s atisfied with the method. Eleven percent of couples conceived during the st udy and one-third of this group said that they had not had relations during the woman's fertile period. Among the 301 couples who discontinued method use for reasons other than pregnancy, the principal reason was personal fac tors. The only demographic characteristic that was significantly associated with continuation and pregnancy rates was age. Conclusion: A fairly simple natural method is potentially effective and hig hly acceptable among the Mayan population of Guatemala.