Introduction: The lactational amenorrhea method (LAM) of postpartum contraception is more effective than typical use of condoms or birth control pills. However, LAM may be underutilized due to incomplete perinatal counseling.Methods: We compared perceptions of the effectiveness of postpartum contraceptives including LAM among US-born nulliparous pregnant women recruited using social media for a trial (NCT 04601987). We used descriptive statistics to summarize data.Results: Of 760 individuals screened, 627 were invited to participate, and 451 (72%) enrolled.Most (81%) had a college degree; 79% intended to breastfeed for at least 1 month. Only 8% believed exclusive breastfeeding reduces the chance of pregnancy "a lot" within 6 months of delivery and 2% indicated that exclusive breastfeeding is typically more effective than birth control pills or condoms. Compared to those planning to use other postpartum contraceptives, the 17% of respondents who planned to use LAM were more likely to know that breastfeeding delays return of menses (84% vs 44%, p=<0.0001) and provides protection from pregnancy until menses return (54% versus 22%, p=<0.0001). Although 25% of those planning to use LAM believed exclusive breastfeeding reduces pregnancy risk by "a lot," only 5% thought LAM is more effective than birth control pills and only 9% that it is more effective than condoms.Conclusions/Implications: First-time US mothers are often unaware of breastfeeding's effects on menses and fertility. Clinicians providing counseling about postpartum contraceptive options should include more information on LAM.
INTRODUCTION:Lactational amenorrhea method (LAM) is a temporary postpartum contraceptive method that is typically more effective than use of condoms or birth control pills. However, this method may be underutilized due to incomplete knowledge.METHODS:To assess perceptions of the effectiveness of LAM compared to other postpartum contraceptives in 2021, we used social media to recruit US-born nulliparous pregnant women carrying a singleton pregnancy of 28+ weeks’ gestation. Participants were compensated a $20 gift card for completing an online survey. Institutional review board (IRB) approval was obtained.RESULTS:Of 152 respondents, 76% were college-educated, 90% wanted to breastfeed, and 7% indicated they planned to rely on LAM as their sole method of contraception in the first 6 months postpartum. However, less than half (48%) were aware that breastfeeding would delay the return of menses after the baby is born, and only 47% believed exclusive breastfeeding reduces the chance of pregnancy within 6 months of delivery. Only 9% (95% CI 5%-14%) knew breastfeeding prevents pregnancy when their infant is exclusively breastfed, while 27% (95% CI 20%-35%) knew breastfeeding only protects mothers from pregnancy until menstrual periods have returned. No respondents indicated that exclusive breastfeeding is typically more effective than condoms and only 2% (0%-6%) indicated that exclusive breastfeeding is typically more effective than birth control pills.CONCLUSION:Few US pregnant women are aware of LAM criteria or the effectiveness of LAM compared with other postpartum contraceptive options, suggesting that patients may be receiving incomplete counseling from their health care providers regarding their options for postpartum contraception.
contraception until the postpartum visit, women choosing contraceptive methods other than immediate postpartum LARC also had a higher rate of SIP (12.6%) when compared with the LARC group (4.0%, P50.003). After adjustment for potential confounders including nulliparity, young maternal age, and married status, SIP was lower with immediate postpartum LARC [AOR 0.27 (95% CI 0.18, 0.64), P5.003] and higher by married status [AOR 1.89 (95% CI 1.26, 2.84), P5.002].CONCLUSION: Implementation of an immediate postpartum LARC program decreased SIP rates. Improved counseling about the impact of immediate LARC placement for family planning is encouraged.
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