Mother Nature & Reproduction: Standard Days Method® Using CycleBeads®
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Mother Nature & Reproduction: Standard Days Method® Using CycleBeads®

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National Reproductive Health Conference Presentation, 2012

National Reproductive Health Conference Presentation, 2012

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    Mother Nature & Reproduction: Standard Days Method® Using CycleBeads® Mother Nature & Reproduction: Standard Days Method® Using CycleBeads® Presentation Transcript

    • Mother Nature &Reproduction:Standard DaysMethod ® UsingCycleBeads® Kimberly Aumack Yee and Katherine Lavoie Cain NATIONAL RH CONFERENCE – New Orleans August 5, 2012
    • Learning Objectives1. Demonstrate basic knowledge of Standard Days Method® and CycleBeads®2. Demonstrate how to screen and counsel clients on the method3. Identify strategies and tools for integrating the method into programs
    • “I always wanted to do thecalendar thing, but I never knewhow.”“I like this method because I can’tuse hormones.”“I don’t like the idea of something inme all the time and that I can’t takeout.”“It’s natural, easy, simple.”“You can involve men.”“It’s a great educational tool, ifanything. I never knew, none of usknew, the exact dates [when onecan get pregnant].”
    • Fertility awareness-based methods Symptothermal
    • Standard Days Method®using CycleBeads® THE BASICS
    • Standard Days Method®  Helps a couple avoid pregnancy by identifying the woman’s fertile days  Identifies days 8 to 19 of the menstrual cycle as fertile days  Is appropriate for women with cycles between 26 and 32 days long (about a month long)  Does not protect against STIs/HIV
    • CycleBeads®The Standard Days Method isused with CycleBeads®, acolor-coded string of beadsto help a woman:  Track her cycle days  Know when she is fertile  Monitor her cycle length
    • How to use CycleBeads®
    • Determining the Fertile Window Ovulation 5 days 12 to 24 hours (sperm viable) (ovum life) Day 8 Day 19
    • Research  Efficacy: failure rate of 4.8 with correct use; 12.0 with typical use (similar rates seen in follow up studies)  Couples use the method correctly in 97% of cycles  67% still using the method 2 years later (range from 60-77% in other studies)  Attracts users not currently using another methodArevalo M et al., Contraception, 2002;65:333-338.Gribble J et al., Contraception, 2008;77:147-154.
    • Effectiveness Spermicides Female condom Standard Days Method Male condom Oral contraceptives DMPA IUD (TCu-380A) Rate during perfect use Female sterilization Rate during typical use Implants 0 5 10 15 20 25 30 Percentage of women pregnant in first year of useSource: Contraceptive Technology Communications, 19th RevisedEdition. 2008; updated 2009.
    • CycleBeads Counseling
    • CYCLEBEADS COUNSELING 1Screening the client
    • Screening a Is the woman’s cycle the right length to use CycleBeads? b Will the method work for the couple?
    • a Is her cycle the right length to use CycleBeads? Is her cycle between 26 and 32 days long? Ask simple questions to assess cycle length and regularity: About how often do your periods come? Do your periods usually come about a month apart?
    • When to start using CycleBeads Client knows date of her START IMMEDIATELY last period Client does not START ON FIRST DAY know date of OF NEXT PERIOD her last period
    • Case 1: Ruth Date of last menstrual period: April 8 Date of visit to clinic: April 14 Her periods come when she expects, about a month apart. She is not breastfeeding and has never used a hormonal BCM. Q: Can she use CycleBeads? A: Yes Q: If suitable, when can she start using it? A: Immediately Q: Possible recommendations? A: Give standard advice— monitor cycle length over time, discuss with partner, place the ring on the correct bead.
    • Case 2: Mercedes Date last menstrual period: Beginning of month(does not remember exact date) Date of visit to clinic: May 20 Her periods always come when she expects them, about a month apart, and she has not been using a BCM. Q: Can she use CycleBeads? A: Yes Q: If suitable, when can she start using it? A: Wait until her next period starts Q: Possible recommendations? A: Use another method until the 1st day of her next period, when she puts the ring on red bead. Monitor cycle length over time. Discuss with her partner. (If she already had sex during this cycle she may be pregnant.)
    • Special circumstances can affectcycle length Postpartum/ breastfeeding WAIT UNTIL PERIODS ARE ABOUT A MONTH3-month Injection, pill, APART (SEE INSTRUCTIONS)patch, implant, IUDEC, miscarriage or WAIT UNTIL NEXTabortion (previouscycles within range) PERIOD STARTS
    • Case 3: VickiDate last menstrual period: October 25Date of visit to clinic: October 30Vicki stopped using the pill about one month ago. She hashad two periods since she discontinued the pill. The periodswere about a month apart. Prior to using the pill her cycleswere regular.Q: Can she use CycleBeads? A: Not yetQ: If suitable, when can she start using it? A: When her last three periods have been about a month apart (26-32 days).Q: Possible recommendations? A: Use CycleBeads to track cycle length while using a barrier method. Help her put the ring on the correct bead. When she gets her next period (if it comes between the dark brown bead and the red bead) she can start using CycleBeads.
    • Screening a Is the woman’s cycle the right length to use CycleBeads? b Will the method work for the couple?
    • b Will CycleBeads work for the couple?Can you and your partner use a condom oranother barrier method, or abstain from sexualintercourse, for 12 days in a row each month? Using CycleBeads does not protect against STIs/HIV!!!
    • 2 Teaching the clientCYCLEBEADS COUNSELING
    • Using CycleBeadsTeach the client:• How to track her cycle to know if she is on a fertile day• How to use CycleBeads to monitor her cycle length each month
    • How to use CycleBeads
    • Monitoring Cycle Length• Periods must always come between the darker brown bead and red bead.• If period comes early (before darker brown bead) or late (does not start the day after the last bead) more than once in a year, switch to another method.
    • Practice Teaching CycleBeads
    • Alternatives to CycleBeads iCycleBeads™ Smartphone app iCycleBeads™ Online
    • CYCLEBEADS COUNSELING 3Supporting the client
    • Support: Method use Put the ring on the correct bead (if possible) Refer to the insert & calendar in the packet Discuss what to do if she has unprotected sex on a fertile day Discuss what to do if she has out-of-range cycles
    • Involving MenSDM is a couple method. If men understand themethod, couples are more likely to use it correctly.How would you involve men?
    • Supporting Couple’s use ofCycleBeads  Encourage her to discuss CycleBeads with her partner  Offer to talk with her partner  Discuss options for handling the fertile days  Ask how she will let partner know when she is on a day that she can get pregnant  Discuss ways her partner could help with method use (marking calendar, etc.)
    • “It’s easier to talk about fertility,and now we share responsibilityfor sex.”“When it’s not a white beadday when there is a need to usecondoms, it feels moreintimate.”“There is less stress in therelationship because mypartner and I know when wecan have unprotected sex andwhen I can get pregnant.”“We can talk about birthcontrol more easily and havebetter communication now.”
    • When to Return to the Provider Unprotected sex on a white-bead day Difficulty handling the fertile days Cycles that are too short or too long If your period has not returned and you think you might be pregnant If you would like to use another method
    • Demonstration counseling videos viewable at www.CycleBeadsToolkit.com
    • Review: CycleBeads Counseling Demonstrate TEACHINGSCREENING SUPPORTING with TEACHING CycleBeads SUPPORTING Cycle length Male involvement Refer to insert & Will the method calendar work for the If/when to couple? return Monitor cycle length each month
    • Integration ofCycleBeads into FamilyPlanning Services
    • www.CycleBeadsToolkit.com
    • Systems Integration Clinic flow Outreach Billing Client CycleBeads materials supply Counseling
    • Effective counseling & support Offering CycleBeads as an option Providing client- centered counseling Screening Teaching what the dark brown bead means Supporting the couple
    • What users are saying “I never had a way of checking my cycle before. It’s amazing…I can’t believe that something so small can make a difference in your life.” “[I like that] I don’t have to take a pill or injection.” “I’ve used the calendar method before and find that this method is much easier…It’s easier to see when you’re fertile.” “[I like] having more control about when to have sex or not.”
    • For more information, visit: www.CycleBeads.com www.CycleBeadsToolkit.com www.irh.orgTHANK KIMBERLY KATHERINE YOU! AUMACK YEE LAVOIE CAIN kaumackyee@acninc.net klcain@nola.gov