Are You Willing to Risk Getting Pregnant Again So Soon?

Many women consider amenorrhea (absence of periods) as one of the great advantages of breastfeeding. Other women lament the fact that their fertility has not returned by the time they are ready to conceive another child. For those women who celebrate the absence of their periods (the ones who think the pronunciation of amenorrhea sounds suspiciously like “Amen, no horror period!”), is exclusive breastfeeding an effective method of birth control?

If a woman follows the Lactational Amenorrhea Method (LAM) exactly, she has less than a 2% chance of becoming pregnant in the six months after giving birth. LAM has three requirements:

1. The woman’s menstrual period has not returned.
2. The baby is breastfed on demand throughout the day and night with no more than four hours between feedings during the day and six hours at night.
3. The baby is less than six months old.

Is LAM still effective if you’re pumping and bottle-feeding? No. The baby’s suckling at the breast plays a role in suppressing ovulation.

Keep in mind that not everyone feels comfortable with the Lactational Amenorrhea Method of birth control. This Pregnancy Guide article from November 2, 2006, cautions against it:

Some experts believe that if you’re exclusively breastfeeding, you’re protected from pregnancy. The theory goes like this: Breastfeeding curbs hormones that trigger ovulation. Some experts say that as long as you’ve had no periods since you gave birth, are nursing at least every four hours during the day and every six at night, and your baby is less than 6 months old, you won’t get pregnant. But BabyCenter lactation expert Susan Condon says every woman’s body responds differently to the hormonal influences of breastfeeding, so even if you’re nursing your newborn all the time, you might be wise to consider yourself fertile. LAM is risky because you’ll probably ovulate before you get your first period, so you can get pregnant without warning. And studies have shown that getting pregnant too soon after giving birth can increase your chances of pregnancy complications, such as preterm labor, and of having a low-birthweight baby.

I tend to agree that LAM is a bit risky. I believe I ovulated and had a period within eight weeks after giving birth (although my periods subsequently went away due to postpartum hyperthyroidism). LAM would not have been reliable for me.

I still think LAM has its merits, particularly when combined with other natural family planning methods. I highly recommend the book pictured above, Taking Charge of Your Fertility by Toni Weschler (click on that title link for more information about the 10th anniversary edition that just came out on November 1, 2006). Taking Charge of Your Fertility simply and clearly explains how to monitor fertility signs such as basal body temperature, cervical fluid and cervical position. By paying attention to those signs a woman can better prevent or achieve pregnancy as she desires. (Keep in mind that getting an accurate basal body temperature requires adequate amounts of sleep–something rare for most new mothers!)

What do you think? Would you or have you relied on LAM as birth control? Have you experienced difficulty with the return of your fertility while breastfeeding?