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Birth Control Behavioral Methods (cont.)

Breastfeeding and Birth Control

Immediately after childbirth the release of certain hormones from a woman’s pituitary gland is inhibited.  As these hormones are required for ovulation to occur, pregnancy becomes much less likely. The length of the period of hormonal suppression varies widely.  Consistent suppression of ovulation depends upon how often the woman breastfeeds and the length of time since her delivery. Despite continuous nursing, ovulation usually returns within 6 months of delivery.

Breastfeeding used for birth control is also called the lactational amenorrhea method (LAM). This method is based on the principle that breastfeeding prevents your body from producing the hormones required for ovulation and thus, a return to fertility. Some women feel this is a satisfactory form of birth control. ACOG states, "Exclusive breastfeeding helps prevent pregnancy for the first 6 months after delivery, but should be relied on only temporarily and when it meets carefully observed criteria of the lactational amenorrhea method (LAM)."

ACOG recommends that for the best impact on fertility, women should breast feed at least every 4 hours during the day and every 6 hours at night. Any feedings the infant is given aside from breastfeeding should not be more than 5%-10% of its total consumption.  For instance, one formula feeding out of every 10 might increase the chance of failure of LAM failure. If this schedule cannot be followed consistently, then an additional form of birth control should be considered. When the menstrual period returns following delivery, another form of birth control should be employed.

  • How effective: ACOG reports this method to be 98% effective in the first 6 months after delivery if the above criteria are met. Once menstrual bleeding resumes, the risk of pregnancy increases greatly.
  • Advantages: A woman has no menses for several months after this method is initiated.
  • Disadvantages: When a woman is fertile again is uncertain. Frequent breastfeeding may be inconvenient. This method should not be used if the mother is HIV positive. This method does not protect against STDs.

Douching Does not Prevent Pregnancy

Douching is a term which refers to rinsing of the vagina. Many women use water, vinegar, or commercially available products purchased at a pharmacy.  These are then introduced into the vagina with a squeeze bottle or tubing. It has long been thought that women needed to clean their vaginas, in part because of odor. Some women douche after their menstrual periods or after sex to avoid getting an STD. Some actually think douching after sex will prevent pregnancy.

  • Douching is not recommended. Douching can alter the delicate chemical balance and bacteriological environment within the vagina. This may allow a new infection to develop or spread a pre-existing infection into other pelvic organs such as the uterus. This method does not protect against STDs. It may actually increase the chance of developing pelvic inflammatory disease and transmitting sexually transmitted diseases.
  • Douching after sex does not prevent pregnancy. In fact, the practice can increase a woman’s chance for developing an ectopic pregnancy, which may represent a life-threatening condition.

Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology

REFERENCE: Frank-Herrmann P, Freundl G, Baur S, et al. (December 1991). "Effectiveness and acceptability of the sympto-thermal method of natural family planning in Germany". American journal of obstetrics and gynecology 165 (6 Pt 2): 2052–2054.


Medically Reviewed by a Doctor on 7/7/2016
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