Family planning when “green” is queen: Exploring the potential for fertility awareness-based methods (FAM) in U.S. Title X clinics

Despite their efficacy and safety, the availability and use of fertility awareness-based family planning methods (FAM) are low in U.S. Title X clinics. Some FAMs take longer to teach than the average counseling time available. The Standard Days Method (SDM), in contrast, is a simple yet effective FAM that can be taught in a short time. SDM introduction represents a feasible way to mainstream FAM and expand choice by providing an alternative to hormonal methods. Whereas many programs and providers are skeptical of FAM reliability and desirability, recent experience suggests that the renewed cultural interest in “green” or natural products may contribute to increased FAM acceptability. Georgetown University and partners in California and Massachusetts are conducting a study to develop and test a process to introduce SDM in four clinics utilizing the World Health Organization's Strategic Approach for family planning method introduction. This approach, conceived for international programs and now being applied in the U.S., calls for the integration strategy to be developed through a participatory process focusing on client needs and quality services. This paper presents the results of the needs assessment phase, including focus groups to assess potential clients' demand for SDM; provider interviews to assess current knowledge, attitudes and practices; and a site assessment to identify opportunities and challenges to adding SDM to the method mix. Preliminary results suggest that SDM appeals to potential clients and that providers are amenable to offering it. Results will be used to tailor the integration strategy to the clinic settings.