For many women, Fertility Awareness Based Methods (FABM) are remarkable at making our bodies’ cycles much less mysterious and much more understandable. This is no less true than for the postpartum period—yes, even that period after giving birth when hormones are all over the place. Whether you’re charting or not, this can be a confusing time for many women who are hoping to add some space between the new baby and the next one. The good news is there are methods available for women to naturally avoid pregnancy.
Right after labor and delivery, the expulsion of the placenta and baby result in a dramatic shift in a mom’s hormonal makeup. It is safe to assume the two weeks following birth a woman will not ovulate—nursing or not (although intercourse is likely far off the list of priorities at this point!). But what happens with a woman’s fertility cycle after those first two weeks postpartum is unique for every woman based on her environmental factors, hormonal constitution, and her baby’s feeding habits. Once ovulation hormones start activating, many women will find that their cycles to be irregular, long, difficult to chart, and particularly hard to find “infertile days.” So let’s clear up some of this, shall we?
Lactational Amenorrhea Method (LAM)
The idea that breastfeeding prevents pregnancy is actually based in the sound science of how lactation affects reproductive hormones. Prolactin wants to be the dominant hormone. Nursing results in prolactin. Therefore, technically speaking breastfeeding makes your infertile. This is where the idea of the Lactational Amenorrhea Method (LAM) comes from. According to LAM, you can consider yourself infertile if:
1. Your baby is younger than 6 months old.
2. You have not had a period yet.
3. Your baby has not received supplemental food (formula or solids), or artificial nipples (bottles or pacifier).
Item #2 to me is always a bit of a head scratcher—seems the qualification itself disputes the method, but let’s run with it for now.
What complicates things is when women follow mainstream advice on breastfeeding that neutralizes the power nursing hormones have to suppress ovulation. For instance, many women believe the pump produces the same hormonal effect as a baby sucking, but it actually is quite different. A pump works on suction rather than suckling and fails to provide the same stimulation on the nipple as a baby’s latch; as a result, it does not produce as much prolactin. That’s very important to know!
There is also something called ecological breastfeeding (EBF) that extends the period of non-ovulation past the first 6 months and has more rigorous stipulations. This includes co-sleeping, on demand nursing, limited (if any) separation between mother and baby, and no pumps, bottles, or pacifiers. The Fertility Appreciation Collaborative to Teach the Science (FACTS) notes that while EBF is a form of fertility awareness methods for avoiding pregnancy, it is not one with sufficient current research of effectiveness for them to consider it evidence-based.
Still, many women swear by it, while other mothers find meeting all the standards darn well impossible, particularly moms who work outside the home. In our culture today (i.e. not living in a village with people offering helping hands left and right), it can be very hard for moms to sustain without significant exhaustion. Even still—some moms doggedly follow all the rules to a tee, and aunt flo decides to show up anyway. This reminds us the priority of charting biomarkers when it comes to predicting fertile periods.
Charting with other Fertility Awareness Based Methods
The good news is that our biomarkers give us a pretty good window into what’s going on with our hormones. For moms seeking to avoid pregnancy, it’s important to choose a fertility awareness method and pay attention to these biomarkers, rather than believe the blanket statement that nursing moms can’t get pregnant.
LAM and EBF can be used in conjunction with charting, whichever fertility awareness based method a mom decides on. Billings, SymptoThermal (also taught through the Couple to Couple League), and FEMM all have postpartum protocols, and I’d recommend a mother choose one method and stick to it. The most important factor is to work with a certified instructor.
The postpartum period is a transitional time difficult for even the most seasoned charter. Your instructor should help you find which biomarkers you want to prioritize for this particular moment. Because what you need this month might be different than last month. And heaven knows what will be helpful next month.
Thankfully, technology is advancing and there are more options than ever for making charting as seamless as possible. Wearables like temp drop make temping easy for the mom who has unusual (and sporadic) sleep patterns. The Clearblue Fertility monitor gives moms an objective look at hormone levels. And the Ovulation Double Check progesterone strips can work as a nice cross check post ovulation. With the help of these tools, an instructor can help piece together what’s working (or not) for a postpartum mom in deciphering fertile and infertile days.
Lastly, patience is a new mom’s best asset. It really is a season. Those cycles will get back on track, they just need time. According to FEMM’s protocol, it can take up to 6 cycles for hormones to regulate. If after 6 cycles, cycles are still irregular and difficult to decipher, it’s worth looking more in depth at hormonal levels.
So does breastfeeding help to prevent pregnancy? Yes, it can. Should new moms still be recording and paying attention to biomarkers like cervical fluid that tell them about their fertility? Yes. But since every woman’s experience can be so different, charting biomarkers always comes first.
Oh, and kick back, don’t forget to enjoy your new bundle of life!