Context: Mayan couples in Guatemala have very low rates of contraceptive use but have long expressed an interest in natural family planning methods.
Methods: A simple calendar rhythm method of family planning was tested among 301 couples living in two departments in the Guatemalan highlands. The method 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 fewer than seven years of schooling and had never used a contraceptive method—received instruction in how to use the method and were followed up for one year. 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 the calendar or necklace, or abstaining from intercourse for 11 days each month) occurred early in the study, and after one year, couples were highly satisfied with the method. Eleven percent of couples conceived during the study, and one-third of this group said that they had not had relations during the woman's fertile period. Among the 31 couples who discontinued method use for reasons other than pregnancy, the principal reason was personal factors. 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 highly acceptable among the Mayan population of Guatemala.