Many new mothers are reluctant to go in for invasive contraceptives immediately after the infant is born. During these initial months postpartum breastfeeding is used as an interim contraception method. It encourages optimal breastfeeding and is healthy for both infant and mother.
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There is a misconception that while the mother is still breastfeeding her child, she will not conceive, but this is an old wives’ tale. While it is true that the Lactational Amenorrhea Method (LAM) is an accepted family planning method as per the WHO, there are some conditions that need to be met. It is not to be confused with merely breastfeeding.
Who should use the lactational amenorrhea method?
Breastfeeding mother may use the LAM as a contraception method with 98% effectiveness. For LAM to be used as a contraceptive, these three points must hold true:
- The baby needs to be less than six months old.
- The mother should not have had her first period after giving birth to the baby.
- The baby is exclusively on breastfeed, with less than 5 % of food coming from other sources.
Lactation delays the period; however it should be remembered that ovulation will take place before the first period starts. This means that there is a chance of conceiving if the mother is relying only on LAM.
Who should not use the lactational amenorrhea method?
The contraceptive method you choose will depend on your personal preference, your family’s medical history, and issues such as complications during pregnancy, whether there is lactating and breastfeeding.
It is the physical suckling of the breast that stimulates the hormones that prevent ovulation. In case you are using a dummy or a bottle for the actual feeding, then the hormones are not being released. In turn the egg may be released by the ovary and be available for fertilization even before your period returns.
If your period has restarted after the birth of your child, and this duration varies for everyone, then you are at an increased risk of conceiving again, even if you continue to breastfeed your child. As a result, another method of contraception should be employed.
The average number of weeks taken for the period to return after birth of a child is 28 weeks. In women who have low levels of progesterone, the periods will return faster, as soon as 15 weeks after birth for them. Other women may not get their period for nearly 48 weeks after birth. As can be seen, this period differs from case to case.
Women who are on certain medication, such as anti-depressants, should not use LAM as a contraception method. The medication is likely to make the baby sleepier and less likely to breastfeed often, which will affect the ovulation cycle. It will lead to a return of fertility much faster for these women.
Other non-invasive contraceptive methods
Immediately after delivery of a baby there is, usually, no desire to conceive another child. At the same time the trauma of child birth may have left the woman with little desire to go back to the health care provider for a detailed discussion on preventing future pregnancies and selecting an acceptable form of birth control. Here are some methods that the couple can practice naturally at home with no requirement of any prescriptions.
This is usually advised immediately after the birth of a baby to allow the mother’s body a chance to heal. In initial forty day period post birth, there should be no sexual penetration of the vagina. This rest period allows the sutures to heal, uterus to return to normal and hormones to rebalance.
Natural family planning (NFP)
This follows a pattern of abstinence during the fertile period of the ovulation cycle. This is a non-intrusive contraception method that can be used once the mother’s periods have restarted and are in a predictable pattern. By avoiding unprotected sexual intercourse on the fertile days of the menstrual cycle, the likelihood of conception can be greatly reduced.
Pull out method (withdrawal)
This works as a ‘natural’ birth control option. Here the male partner will remove the penis from the vagina during sexual intercourse before he can ejaculate. While it is not always effective as some sperm may enter the vagina before withdrawal, it does lower the risk of conceiving.
This refers to any type of sexual activity which excludes vaginal intercourse. The couple may engage in acts that do not result in penetration of the vagina. Since there is no risk of the semen being ejaculated into the vagina, this is 100% effective as a contraception method. The actual sexual acts will differ based on the preference of the couple.
Reviewed by Afsaneh Khetrapal, BSc (Hons)