Contraceptive use, amenorrhea, and breastfeeding in postpartum women

Data from a 1981-1982 survey of infant feeding practices in four developing countries are used to analyze the relationship of amenorrhea, lactation, and time since childbirth with contraceptive use. The relationship was first explored using contingency table analysis. Logistic regression analysis was then performed to control for the effects of background variables. Models were tested separately for oral contraceptive users and users of other methods. Analysis showed a strong, independent, and consistent negative relationship between amenorrhea and contraceptive use. Women who were less than four months postpartum were also less likely to use contraceptives. The strength of the association with amenorrhea outweighed all other variables, including demographic correlates of contraceptive use. A negative relationship between breastfeeding and contraceptive use was found only for users of oral contraceptives. It is possible that women in the immediate postpartum period, especially those who are lactating and amenorrheic, are not as highly motivated to use contraception as had been supposed.