Lactational amenorrhea for family planning

C, Van der Wijden; Kleijnen, Jos; T, Van den Berk

doi:10.1002/14651858.cd001329

Cited by 46 publications

(30 citation statements)

References 51 publications

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“…18 In contrast a Cochrane review of LAM encapsulates the prevailing consensus that "waiting for the end of amenorrhea before starting to use contraception is not acceptable." 34 Neither of these statements takes any account of the wishes of women or couples. In our view, a top research priority is to ascertain these wishes.…”

Section: Discussionmentioning

confidence: 99%

A Fresh Look at the Level of Unmet Need for Family Planning in the Postpartum Period, Its Causes and Program Implications

Cleland¹,

Shah²,

Beňová³

2015

IPSRH

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One central rationale for the promotion of family planning is the potential benefit to the health of mothers and children. The achievement of adequate spacing between pregnancies is a major pathway through which contraceptive practice can render benefits. Pregnancies conceived less than 20 months following a prior birth are at considerably higher risk of prematurity, low birth weight, fetal death and early neonatal death. 1 The importance of this link is underscored by the facts that neonatal deaths account for 44% of all childhood deaths and that prematurity is the most common cause. 2 In addition to the 2.9 million neonatal deaths that occur each year, 99% in low-and middleincome countries, an almost equal number of stillbirths occur. 3 An analysis of Demographic and Health Survey (DHS) data from 52 countries showed that the adverse effects of inadequate spacing extend beyond the neonatal period. 4 Expressed in terms of interbirth intervals, children born within 24 months of an elder sibling have a 60% increased risk of dying before their first birthday and those born 2-3 years after an elder sibling have a 10% increased risk, compared with those born after an interval of 3-5 years. For children between the ages of one and five years, the balance of evidence suggests that intervals of less than two years are associated with a 40% increased risk of dying. A systematic review confirmed that the health of mothers is also affected by inadequate spacing. 5 Specifically, short intervals are associated with uterine rupture and uteroplacental bleeding disorders. Despite the steep rise in contraceptive use in developing countries, interbirth intervals have increased in length only slightly over the past 25 years; according to recent surveys, 25% of second and higher-order children are born within two years of a sibling, compared with about 29% a decade earlier. 6Though this evidence underlines the importance of postpartum family planning for the health of both mothers and children, the topic suffered a prolonged era of benign neglect that has only recently been remedied. In 2013, the World Health Organization issued new guidelines for this component of contraceptive services and the U.S. Agency for International Development is funding projects to provide postpartum services. 7,8 One factor that helped to revitalize this agenda was a study of women in 27 countries by Ross and Winfrey in which the proportion who wanted to postpone another child for at least two years but were using no method of contraception was, on average, at the very high level of 65% in the first year following childbirth. 9 Indeed, their analysis suggested that 39% of all unmet need for contraception arose from women who had given birth in the previous 12 months. For decades, the concept of unmet need has been the main way of prioritizing populations for delivery of family planning services, and thus Ross and Winfrey's article had a major impact. However, their findings are perplexing because it is well established that most couples wish to space su...

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Section: Discussionmentioning

confidence: 99%

A Fresh Look at the Level of Unmet Need for Family Planning in the Postpartum Period, Its Causes and Program Implications

Cleland¹,

Shah²,

Beňová³

2015

IPSRH

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“…As far as long-term outcomes are concerned, literature has shown that breastfeeding reduces fertility in the mother, perhaps for several months, affording a natural form of birth spacing. A Cochrane review by Wijden et al [257] concluded that fully breastfeeding women who remain amenorrhic have a very small risk of becoming pregnant in the first 6 months after delivery when relying on lactational subfertility [258][259][260][261][262][263][264][265]. Pooled estimates from the Lancet Maternal and Child Undernutrition Series [266] show that individual counseling increased the odds of exclusive breast feeding by a factor of 3.45 in the neonatal period (OR 3.45; 95% CI: 2.20 to 5.42) and by a factor of 1.93 at 6 months of age (OR 1.93; 95% CI: 1.18 to 3.15).…”

Section: Support and Promotion Of Early Initiation And Continued Breamentioning

confidence: 99%

The interconnections between maternal and newborn health – evidence and implications for policy

Lassi

Majeed

Rashid

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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The past decade has witnessed increasing global attention and political support for maternal, newborn and child health. Despite this increased attention, actual progress has been slow and sporadic: coverage of key maternal and newborn health interventions remains low and there are wide disparities in access to care, within and across countries. Strategies for improving maternal and newborn health are closely linked, and can be delivered most effectively through a continuum of care approach. While these interventions are largely known, there is little information on which interventions have a positive health impact for both women and newborns. This supplement identifies the interventions during the preconception, pregnancy, intrapartum and postnatal periods found to have a positive, synergistic effect on maternal and neonatal outcomes. These interventions are then grouped into packages of care for delivery at the community, health center or hospital levels.

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“…22 The beneficial effects of exclusive breast feeding on the infant are important additional advantages. w8…”

Section: Does Evidence Support the Use Of Natural Contraceptive Methods?mentioning

confidence: 99%

Contraception for women: an evidence based overview

Jj¹,

Tripathi

2009

BMJ

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Lactational amenorrhea for family planning

Cited by 46 publications

References 51 publications

A Fresh Look at the Level of Unmet Need for Family Planning in the Postpartum Period, Its Causes and Program Implications

A Fresh Look at the Level of Unmet Need for Family Planning in the Postpartum Period, Its Causes and Program Implications

The interconnections between maternal and newborn health – evidence and implications for policy

Contraception for women: an evidence based overview

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