Postpartum contraception: The lactational amenorrhea method

Author(s):  
M. Vekemans
Author(s):  
Vidyadhar B. Bangal ◽  
Sunil Thitame ◽  
K. V. Somasundaram

Background: The choice of a contraceptive method is a complex decision. Health care providers have an important role in providing information and supporting patients' decision making about contraceptive choices through counselling. Non-use of contraceptive methods, use of less effective methods, and incorrect and inconsistent use of methods underlie the high frequency of unintended pregnancy. Prospective cross-sectional study was undertaken to study the role of peri-partum counselling in improving choice of postpartum contraception at Pravara Rural Hospital Loni, Ahmednagar, Maharashtra, India.Methods: Four hundred and fifty women in third trimester of pregnancy were individually counselled about the postpartum contraception, using educational material and pamphlets. The choice of postpartum contraception before and after the counselling was noted.Results: Among primi gravidas, the most favored choices for postpartum contraception before counselling were condom (25%) and lactational amenorrhea method (12%). In the same group of women, the post counselling choices were PPIUCD (45%), condom (17%) and interval IUCD (7%). Among multi-gravida, the most favored choices for postpartum contraception before counselling were postpartum tubal ligation (26%), condom (20%) and lactational amenorrhea method or calendar method (17%). In the same group of women, the post counselling choices were postpartum tubal ligation (32%) PPIUCD (12%), condom (8%).Conclusions: The study supports the usefulness of good quality counselling both with respect to the interpersonal relationship between the patient and the provider and quality of information that is provided during counselling. Postpartum intrauterine contraceptive device (PPIUCD), a long acting reversible contraceptive, will fulfil the felt need of postpartum contraception in near future.


1998 ◽  
Vol 14 (3) ◽  
pp. 209-218 ◽  
Author(s):  
Kathy I. Kennedy ◽  
Milton Kotelchuck ◽  
Cynthia M. Visness ◽  
Afroze Kazi ◽  
Rebecca Ramos

Author(s):  
Kamlesh Tiwari ◽  
Ishmat Khanam ◽  
Neha Savarna

Background: The lactational amenorrhea method, known as LAM, is part of the World Health Organization’s list of accepted and effective methods of family planning. Studies show LAM to be 98% effective, as effective as the pill and other modern methods, when used according to guidelines. As LAM costs nothing, easy and natural to use, no medication or any devise needed, no interference with natural hormones, no interruption in conjugal life and more over the mother enjoying her motherhood life, it sounds very good as a method of contraception.Methods:This is a prospective non-comparative study. A total of 298 mothers participated in this study. The benefits of exclusive breast feeding with particular emphasis on timely breastfeeding and must feeding during the night hours were explained to the mothers and the physiology of lactational amenorrhea was explained to them. All the mothers were interviewed and followed up on monthly basis. Results:No lactating mothers conceived within the first six months of delivering their baby and only 4% mothers had evidence of pregnancy mainly after the 10th months after delivery.Conclusions:The lactational amenorrhea method is a highly effective method of contraception for 6 months if exclusive breastfeeding practices are followed. In a country like India where use of contraceptive methods are very meager, LAM may prove a boon as it provides dual benefit of exclusive breastfeeding and prevention of pregnancy.


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