Gender, sexuality and communication issues that constitute barriers to the use of natural family planning and other fertility awareness-based methods

Fertility awareness-based methods of family planning are rarely offered through reproductive health services in Latin America, despite evidence that many women use them. Providers state that clients do not want these methods, but provider-bias is evident. Providers overestimate the difficulty of learning and using fertility awareness-based methods, and they underestimate their efficacy. Both providers and clients have difficulty dealing with sexuality (which is central to fertility awareness-based methods). Many providers lack gender sensitivity, 'worsening' the unequal relationship between providers and clients. Experience has shown that when fertility awareness-based methods are well provided, they can have a positive effect on sexuality, self-understanding, and equality in the couple's relationship.