Lactation-induced amenorrhea as birth control method
Van Unnik, G.A.; van Roosmalen, J.
Nederlands Tijdschrift Voor Geneeskunde 142(2): 60-62
1998
ISSN/ISBN: 0028-2162 PMID: 9556994 Document Number: 283416
In 1966 WHO published a document on improving access to quality care in family planning, which who pronounced to be a fundamental human right. According to this document, despite the assortment of reliable contraceptives worldwide 350 million people have unmet need for contraception because of lack of access or availability. Adequate reproductive health depends not only access to contraceptives, but also on adequate screening and treatment of anemia, sexually transmitted diseases, and cervical carcinoma. Among 8 groups of birth control methods studied, the lactational amenorrhea method (LAM) was dealt with in detail. The underlying mechanism lies in the stimulation that breastfeeding brings about and in breastfeeding's suppression of the release of gonadotropin- releasing hormone and of dopamine (the prolactin inhibiting factor). A 1974 investigation in Rwanda demonstrated that 50% of rural women who breast fed their children frequently got pregnant within 23 months of childbirth and that 50% of city women became pregnant 9 months postpartum. The Bellagio consensus has stated that LAM provides 98% protection against pregnancy in the first 6 months postpartum as long as breast feeding is the exclusive feeding method practiced. A 1992 analysis of 9 prospective studies reported that 6 months postpartum only 0.7% of the women using LAM became pregnant. LAM still plays a crucial role in Africa, where the average number of children per woman is 6. Without breastfeeding the estimated figure would be 10.