EFFECTIVENESS OF THE LACTATIONAL AMENORRHEA METHOD IN PAKISTAN

Objective: To determine the efficacy of the lactational amenorrhea met hod of family planning (amenorrhea during full or nearly full breastfe eding for 6 months postpartum). Design: Prospective noncomparative stu dy. Setting: Normal breastfeeding women in Karachi and Multan, Pakista n, most delivered at home by a midwife. Patients: Three hundred ninety -nine newly delivered mothers who successfully had breastfed a previou s child and chose the lactational amenorrhea method to prevent a subse quent pregnancy, 391 of whom were followed for a full year. Interventi ons: Mothers were taught, before or shortly after delivery, to use the method and were interviewed in their homes each month by a Lady Healt h Visitor. Main Outcome Measure: Life-table pregnancy rates. Periods o f postpartum or lactational abstinence were excluded in the calculatio n of the pregnancy rates. Results: During full or nearly full breastfe eding, while the women were amenorrheic and not otherwise contraceptin g, the rate of pregnancy was 0.6%. The pregnancy rate during lactation al amenorrhea alone was 1.1% at 1 year postpartum.Conclusion: The lact ational amenorrhea method was found to be highly effective for 6 month s. A high degree of contraceptive protection endures for a full year d uring lactational amenorrhea, but not after the return of menses durin g breastfeeding.