As a board-certified lactation consultant and fertility awareness educator, I commonly encounter a misconception among my clients that you can’t effectively use Fertility Awareness Methods (FAMs) while breastfeeding. Yes, I’ll admit, it’s trickier to chart your body’s signs of fertility (like cervical mucus) while breastfeeding, because many women don’t cycle regularly as long as they are nursing or pumping. Still, with the right support and tools, charting while breastfeeding is entirely doable.
Does breastfeeding delay the return of fertility?
First, let me bust the myth that breastfeeding completely suppresses the return of cycles and thus fertility.
Biologically, a lactating mom has high amounts of the hormone prolactin. Prolactin spikes every time a mom has a milk letdown, which essentially occurs every time she nurses, and, to a lesser degree, whenever she pumps. Prolactin sends a negative feedback loop to the pituitary gland to suppress communication to the ovaries, meaning that for some length of time, ovulation itself is suppressed. This is actually quite similar to how hormonal contraception works–although prolactin is a naturally occurring hormone, while synthetic progestin in hormonal contraception is artificial. So, yes, breastfeeding in general suppresses fertility for a time. (More on utilizing the criteria of Ecological Breastfeeding or Lactational Amenorrhea Method to reliably delay the return of fertility longer-term can be found here and here.)
But there are two important pieces of information to add to this. The first is that because ovulation occurs before menstruation, you can get pregnant before your first period after giving birth (I’m referring to bleeding that is separate from the lochia that is expelled in the first six or so weeks after birth, and is actually composed of much more than just blood).
Let’s be clear, too, that a period is, by definition, preceded by ovulation. So, you might ovulate first or you might have a bleed first before your cycle returns, but bleeding not preceded by ovulation is a bleeding episode (sometimes called a breakthrough bleed) and not a true period. The second thing is that the return of ovulation varies wildly from woman to woman and even from one postpartum experience to another for the same woman. Ovulation can resume as early as 8 weeks postpartum–Yes! Even while breastfeeding. On the other hand, some women will go two years after their baby’s birth without ovulating.
The key to successful postpartum charting if you’re avoiding pregnancy
So the core of charting postpartum if you’re seeking to avoid pregnancy is catching the first ovulation…..before it happens. The usual biomarkers like temperature and LH tests are helpful at confirming ovulation after the fact, but cervical fluid is the single best real time biomarker to catch the opening of the window of fertility before that first ovulation.
The tricky part is that cervical fluid can be the most subjective biomarker, so women often feel a bit nervous about relying on their interpretations of it exclusively. This is why working directly with an instructor trained in your chosen method of fertility awareness is so key postpartum.
This tool helps many women anticipate the return of fertility
One tool is becoming increasingly popular among women seeking help in deciphering their postpartum signs of fertility. The Marquette Model of Natural Family Planning (I’ve written about my personal use of it here) uses the Clearblue monitor, which measures both estrogen and LH. That means it gives objective low/high/peak readings based on these measurements, and gives a clue to the window of potential fertility before ovulation. Marquette is a very popular choice for charters who are breastfeeding, and tends to translate to significantly fewer days of abstinence for postpartum women seeking to avoid pregnancy when compared to mucus-only methods of fertility awareness.
Because the monitor is in no way designed for postpartum and was exclusively designed for women trying to conceive, the Marquette Method creators developed a protocol to work around this that involves periodically resetting the monitor. In my opinion, it’s not prohibitively difficult, but it is certainly clunky.
No one-size-fits-all postpartum fertility awareness method
I work with women postpartum who have varied needs. For some, the Clearblue monitor makes sense and they want that objectivity. Other women prefer to just go off of cervical fluid and add temperature observations when they think ovulation is close. I also work with women who don’t pick up the Clearblue monitor unless they become confused about their cervical fluid observations. The main takeaway I have found working with postpartum clients is: you have options for charting postpartum, and with the right support–namely, working with an instructor who is familiar with the postpartum and its charting protocols–you should feel confident and supported the entire way.
The bottom line about postpartum charting
Postpartum charting doesn’t have to be scary. Doctors, friends, and relatives may be quick to shout that breastfeeding doesn’t prevent pregnancy. Others may wave their hands nonchalantly, saying that breastfeeding is birth control enough. The answer is somewhere in the middle. Breastfeeding does prevent ovulation for some time. Ovulation does eventually return, and the timing varies by woman and by pregnancy. You will ovulate before you have your first postpartum period, and pregnancy can definitely occur on the first ovulation if you do not abstain during your fertile window. But the good news is, all of these events are trackable.
If you’re feeling nervous about charting postpartum, even if you’ve done it before or taken a class previously, get in touch with your instructor. A refresher could be just the ticket. Learning fertility awareness for the very first time while postpartum? Check out your options for learning a method here and get a free 15-minute consultation with a fertility awareness expert here.