Das Konzeptionsrisiko während der Stillperiode

Abstract

The contraceptive effect of lactation is undisputed. Nursing increases the prolactin level in the serum. This hyperprolactinaemia suppresses all levels of the hypothalamus-hypophysis-ovary axis. The risk of ovulation can be greatly reduced by a proper nursing routine, frequency of nursing being credited with a greater anovulatory effect than duration of nursing. In addition, full nursing increases contraceptive safety. To prevent a drop in the serum prolactin level, nursing should also be done at night-time. Amenorrhoea during the lactation period is one of the most important prerequisites for an adequate contraception. The risk of ovulation increases dramatically, if vaginal bleeding occurs. However, the first cycles in the lactation period are often anovular and characterized by corpus luteum insufficiency. Lactation-induced amenorrhoea, nursing frequency of at least 6 x/day, nursing duration of at least 60 minutes/day, additional feedings of maximum 1 x/day and nocturnal nursing are the requirements for sufficient nursing-induced contraception. Even if these requirements are fulfilled, the risk of ovulation increases with the length of time post partum. Effective contraceptive protection is attained only up to the 9th p.p. week. If high post partum contraceptive safety is required, a mini-pill or micro-pill must be recommended. Lactation can only be recommended as a moderate contraceptive measure even in this case, an additional method (chemico-mechanical) should be initiated 3 months post partum.