Effectiveness of a Postpartum Breastfeeding Protocol for Avoiding Pregnancy

Area of Science:

• Reproductive Health
• Family Planning
• Fertility Awareness-Based Methods

Background:

• Traditional postpartum fertility indicators (cervical mucus, basal body temperature) are associated with high unintended pregnancy rates.
• A 2013 study demonstrated reduced pregnancies using urine hormone signs in a postpartum/breastfeeding protocol.

Purpose of the Study:

• To evaluate the effectiveness of a revised postpartum/breastfeeding fertility awareness protocol in preventing pregnancy.
• To determine correct and typical use pregnancy rates for the updated protocol.

Main Methods:

• A revised protocol involved increased testing days with a fertility monitor and optional evening luteinizing hormone tests.
• Instructions were provided for managing the fertile window during the first six postpartum cycles.
• Kaplan-Meier survival analysis was used on data from 207 postpartum breastfeeding women.

Main Results:

• Total pregnancy rates (correct and incorrect use) were 18 per 100 women over 12 cycles.
• Correct use pregnancy rates were 2 per 100 women over 12 cycles.
• Typical use pregnancy rates were 4 per 100 women over 12 cycles.

Conclusions:

• The revised postpartum/breastfeeding protocol demonstrated fewer unintended pregnancies compared to the original method.
• While effective, the revised protocol incurred higher costs.
• Hormone monitoring offers a viable option for postpartum family planning.