CONTRACEPTIVE USE AND PREGNANCY BEFORE AND AFTER INTRODUCING LACTATIONAL AMENORRHEA (LAM) IN A POSTPARTUM PROGRAM

There is good evidence that lactational amenorrhea (LAM) is an effecti ve method of fertility regulation during the first 6 months postpartum , provided no other food is given to the baby and the mother remains a menorrheic. However, although breast-feeding is strongly promoted in m any maternity hospitals that also run postpartum family planning proga ms, LAM is rarely included among the contraceptive options being offer ed. This paper presents the results of an operational study which comp ared the prevalence of contraceptive use and the cumulative pregnancy rate at 12-months postpartum among 350 women observed before and 348 w omen studied after introducing LAM as an alternative contraceptive opt ion offered to women following delivery at the Institute Materno-Infan til de Pernambuco (IMIP), in Recife, Brazil.The percentage of women no t using any contraceptive method was significantly lower (p<0.0001) af ter the intervention (7.4%) than before (17.7%). This difference remai ned statistically significant after controlling for age, number of liv ing children, marital status and years of schooling. The proportion pr egnant one year postpartum was also significantly lower (p<0.0001) aft er the introduction of LAM (7.4%) than before (14.3%), but the differe nce was no longer significant after controlling for the same variables . It is concluded that LAM is a useful addition to family planning pos tpartum programs.