On breastfeeding, fertility awareness, and not getting pregnant
If you are pregnant, there is a great chance that your OB/GYN or a nurse will ask you what form of contraceptives you’re going to use after you deliver. I heard mothers tell me how hospital staff would push the Pill on them little before or after they had delivered. I personally find it quite insensitive and distasteful. If you’re planning on breastfeeding, you can tell them with confidence that it is your method of “birth control” along with fertility awareness. If they start arguing with you and try to discourage you, refer them to this article. Even if they don’t trust you, you can trust yourself, when you have all the information.
Fertility awareness while breastfeeding may sound counterintuitive to women because when you’re breastfeeding, your cycles change and the signs are affected. That’s why women have questions like:
- Is breastfeeding itself an effective method of natural birth control?
- Can I be fertile and get pregnant while I’m breastfeeding?
- Can I chart accurately to know if I’m fertile or not while I’m breastfeeding?
- Does my method of fertility awareness or natural family planning still work while I’m breastfeeding or do I need to change what I’m doing?
- Where should I go for good information on this topic?
This article is not a scientific white paper on this extensive topic, but I’m hoping to help answer these questions in a succinct way and guide you to further useful information.
1. Is breastfeeding an effective natural birth control?
Yes, breastfeeding does affect your fertility and in some conditions can be an effective form of birth control. Lactational Amenorrhea is a complicated term to describe the connection between nursing and the continued absence of periods (and fertility). Ecological Breastfeeding and Lactational Amenorrhea Method (LAM) are particular ways of breastfeeding that are widely used to postpone a pregnancy.
- A 1997 study of LAM involving 519 sexually active women in 11 sites throughout the world showed a 98% success rate.
- Ecological Breastfeeding reports a 0% chance of pregnancy for first 3 months, 1% chance for the next 3 months, and 6% chance after that, assuming no abstinence and no fertility charting at all.
Keep in mind that these family planning methods are accomplished without contraceptives or any chemicals in your body! However, if you’re not following these methods or prefer additional insurance, you should watch for the signs of fertility.
2. Can I be fertile and get pregnant while I’m breastfeeding?
Yes. For instance if you’re not breastfeeding almost exclusively and use supplemental bottles and start early feeding solids to your baby, there is a high chance that your fertility will come back within six months. As soon as you get your first periods after you give birth, you may be fertile, and even before the first period happens. In general, about 35% of breastfeeding women will ovulate prior to getting their first menstrual period, so it’s beneficial to chart! You can chart you fertility from the beginning after delivery of your baby.
3. Can I chart accurately to know if I’m fertile or not while I’m breastfeeding?
Definitely. I asked local natural family planning teachers and this is what they say:
“I’ve taught many breastfeeding women and they have quickly and confidently learned their days of fertility and infertility,” said Tina Luther, teacher of the Creighton FertilityCare method. “While breastfeeding, there is (typically) not a menstrual period, so it’s a continuous chart. Women chart what they see– their most fertile sign at the end of the day. So we teach them how to discern their days of fertility.”
“The best way to answer the breastfeeding ladies is to tell them that fertility signs can always be charted, but you need to know what you are looking for,” says Cathy Nix, teacher of the symptom-thermal method with Couple to Couple League. “The return to fertility is signaled by the presence of mucus and the temperature sign. At the first sign of mucus, it is recommended that a woman start to chart again and take her temp.”
Billings, another widely used method, offers a similar recommendation on their website: “When a woman is breastfeeding she remains infertile for a variable time. During this time she experiences, at the vulva, either a continuing sensation of dryness, or an unchanging discharge. The appearance of blood, or any change in the mucus or sensation alerts her to the possibility of her returning fertility.”
4. Does my method of fertility awareness or natural family planning still work while I’m breastfeeding or do I need to change what I’m doing?
As I mention above, natural family planning methods have a process to help you read the signs of your fertility with accuracy. As I always recommend, when in doubt take the time to ask a teacher. If you haven’t learned a method yet, now is a great time to start. Some methods have more extensive classes about Ecological Breastfeeding to teach you how to manage the return of your fertility. All will help you with the specifics of charting, especially how to identify true cervical mucus after childbirth.
5. Where should I go for good information on this topic?
If you have an NFP teacher already, I highly recommend talking to her. If you don’t, below are some sources of information.
About charting while breastfeeding click on links below:
- The Couple to Couple League
- Billings Ovulation Method
- Creighton FertilityCare™ System
- Family of the Americas
- Marquette Method
For other tips:
A reason to consider these methods is that hormonal contraceptives can have a negative impact on breast milk production. The World Health Organization has some minimal restriction concerning contraceptives pills for breastfeeding mothers. For instance prior to 6 weeks postpartum the use of progestogen-only contraceptive methods are not recommended as they could have a negative impact on the baby’s developing brain. This makes a statement about how these hormones are found in the mother’s milk. Why would you take the risk to feed such a drug to even an older child?
I hope this article has helped you see a better alternative and that you will stay away from hormonal contraceptives. Again, don’t let medical staff too often bent on promoting chemical methods of birth control intimidate you. You and your baby deserve better.
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