Lactational Amenorrhea Method Provides Effective Postpartum Contraception

Abstract

This study examined the effectiveness of lactational amenorrhea in preventing pregnancy during the first 6 months postpartum. Women were recruited during January 1994 to May 1995 from maternity clinics family planning centers and other health care providers. 643 women were screened out of 1425 total women participating in the study. Sample women were recruited from Birmingham England; Dusseldorf Germany; Milan Italy; Merida Mexico; Manila the Philippines; Stockholm Sweden; Washington D.C.; Jakarta Indonesia; Sagamu and Jos Nigeria; and Assiut Egypt. Study participants had to be no more than 3 months postpartum amenorrheic fully or almost fully breast feeding and having sexual intercourse. All women had to agree to accept the lactational amenorrheic method (LAM) for birth control. Women used diaries for recording coital frequency. Women were interviewed at 6 9 and 12 months postpartum. Findings indicate that 324 women (62%) were still using LAM at 6 months. Knowledge of LAM was high. 6-month life table risk of pregnancy based on 2718 woman-months of use was low among women using the method correctly (1.5%). The risk was 1.7% among women who did not adhere to the conditions of use of LAM. 27% of women started contraceptive use 6 months after the birth or after stopping LAM. By 9 months postpartum 68% were using contraception. The desire for spacing of births or stopping of births was 85% at 9 months and 76% at 12 months respectively. 84% were satisfied with LAM. 13% reported problems with LAM. The most problematic report was night feedings and worry about efficacy.