Self-Assessment Questions (SAQs) for Study Session 4

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 4.1 (tests Learning Outcomes 4.1, 4.2 and 4.4)

Give reasons why natural family planning methods may be preferred by some women. What should couples be prepared to do in order to use natural family planning methods effectively?


Natural family planning methods are preferred by women who do not wish to use artificial methods of contraception or who, for reasons of religion, rumours or myths, fear using other methods. Couples with lower levels of education can use natural family planning methods effectively, providing the couple are highly motivated and have been well trained in the method. They should be prepared to avoid sex, or use withdrawal or a barrier method during the woman’s fertile period.

SAQ 4.2 (tests Learning Outcome 4.2)

How reliable are natural family planning or fertility awareness-based methods of contraception?


For many women who know their fertile period and have used a fertility awareness-based method consistently for a long period of time, the method can be reliable. However, the failure rate is higher when compared with other contraceptive methods.

SAQ 4.3 (tests Learning Outcomes (4.2, 4.3, and 4.4)

List the criteria that have to be fulfilled for the effectiveness of LAM in preventing pregnancy.


The criteria are:

  • The woman’s period must not have returned.
  • The baby must be exclusively breastfed day and night.
  • The baby must be less than six months old.

SAQ 4.4 (tests Learning Outcomes 4.4 and 4.5)

W/ro Abebech is three months postpartum and using LAM for contraception. Her baby has just started sleeping for more than six hours during the night.

  • a.Can she continue using LAM as a reliable contraception? State your reasons.
  • b.If not, what would be her first choice of contraceptive method?
  • c.What would be her second best choice of contraceptive method?


  • a.No. If the infant takes more than a six-hour interval between feeds during the night, the mother is advised to start a complementary family planning method.
  • b.The first choice would be a non-hormonal contraceptive, such as condoms, spermicides, diaphragms, IUCDs, or voluntary surgical contraception. This is because these methods do not enter the bloodstream and interfere with the production of breastmilk.
  • c.The second choice would be to provide progestin-only methods, such as progestin-only pills, a DMPA injectable or implants. These methods do not interfere with breastmilk production.

Summary of Study Session 4