USING EVIDENCE TO EXPAND FAMILY PLANNING CHOICES, ADVANCE GENDER EQUALITY, AND INVOLVE COMMUNITIES.

Fertility Awareness Across the Life

Course: What people know, what they don’t

know, and how it influences attitudes and behaviors related to sexual and

reproductive healthDr. Victoria Jennings

Director, Institute for Reproductive HealthProfessor, Department of Obstetrics and Gynecology

Definition: Fertility Awareness

• Actionable information about fertility throughout the life course

• Ability to apply this knowledge to one’s own circumstances and needs

Systematic Literature Review

• Published (or grey) 1990-2013• Degree of fertility awareness

knowledge

• Link effect of fertility awareness knowledge to attitudes or behavior

• Show effect of fertility awareness intervention on knowledge, attitudes or behavior

Systematic Literature Review (1990-2013)

83 articles…

Systematic Literature Review (1990-2013)

Methodologies of the included studies

Current Situation

• Low levels of fertility awareness globally, over life course

• Scarce evidence of effect of fertility awareness on family planning use

• Impact of interventions is not well known

Adolescents

Puberty

Menstruation

Fear Misunderstanding

Teasing/harassment

Missing schoolEarly sexual debutEarly pregnancy

Lack knowledge of… Results in…

Adults

Fertility return post-partum/post-abortion

Variable fertility during menstrual

cycle

Actual pregnancy risk

Non-use of FP− breastfeeding/

post-abortion− infrequent sex − on fertile days

Closely spaced pregnancies

Unplanned pregnancies

Lack knowledge of… Results in…

Adolescents and Adults

How FP methods work

How they affect health

Non-use of FP

Discontinuation

Incorrect Use

Lack knowledge of… Results in…

Older Adults

Declining fertility

Menopause

Infertility/sub-fecundity issues

Unintended late-life pregnancy

Lack knowledge of… Results in…

People Know Less Than They Think They Do!

• False sense of security• Perpetuation of incorrect information• Mis-timed/unwanted pregnancy

Limited research on effect of interventions including

fertility awareness suggests…

• Increased knowledge• Ability to track cycle, prepare for next menses• Fewer days of missed school• Increased use of FP or abstinence• Increased couple communication, women’s

empowerment• Increased FP method continuation

Research Considerations• Clear definition of fertility

awareness• Focus on specific target groups• Take life course perspective• Define interventions• Consider ecological rather than

individual approach

www.irh.orgFertility Awareness Literature Reviewirh.org/resource-library/a-comprehensive-literature-review-fertility-awareness-across-the-life-course/

Fertility Awareness Consultation Reportirh.org/resource-library/meeting-report-lets-talk-about-fertility-awareness/

INCREASED USE OF

FP

FERTILITY

AWARENESS