Effectiveness of Lactational Amenorrhea Method in Ethiopia: A Multi-Center Prospective Cohort Study.
breast-feeding
contraception
effectiveness
lactation amenorrhea
postpartum Ethiopia
Journal
Open access journal of contraception
ISSN: 1179-1527
Titre abrégé: Open Access J Contracept
Pays: New Zealand
ID NLM: 101700100
Informations de publication
Date de publication:
2023
2023
Historique:
received:
03
07
2023
accepted:
01
09
2023
medline:
11
9
2023
pubmed:
11
9
2023
entrez:
11
9
2023
Statut:
epublish
Résumé
Although the lactational amenorrhea method (LAM) is one of the most commonly used contraception methods during the first six months of a woman's postpartum period, there has been little research on its effectiveness in general and particularly in Ethiopia. The purpose of this study was to evaluate the effectiveness of LAM and the experiences of Ethiopian women who used it. This was a multi-center prospective cohort study of postpartum women from five Ethiopian regions and one city administration. All pregnant women who gave birth in these randomly selected hospitals and five health centers directly referring to the hospitals were invited to the study if they selected LAM and were followed monthly at home. Each month, trained researchers visited the woman at her home and collected information about breast feeding, the return of menses, the resumption of sex, the use of another contraceptive, and a pregnancy test using urine human chorionic gonadotropin (hCG). Women who reported starting new contraceptive methods, resumption of menses, starting complementary feeding, neonatal death, getting pregnant, or refusing were excluded from the cohort. The data were collected using ODK Collect and exported to Stata 14 for analysis. Among the 2162 women who selected LAM as a contraceptive, 2022 were enrolled in the cohort study, and 901 completed the follow-up. At the end of the sixth month, eight women got pregnant, corresponding to an effectiveness of 99.1%. More than half of the cohort were excluded from the follow-up for reasons of transitioning to other types of contraception, resumption of menses, or refusal to follow-up. The effectiveness of LAM is high and should be recommended for postpartum women, with proper counseling provided. A study should be conducted to examine the effectiveness of breast feeding as a contraceptive beyond the Bellagio consensus.
Sections du résumé
Background
UNASSIGNED
Although the lactational amenorrhea method (LAM) is one of the most commonly used contraception methods during the first six months of a woman's postpartum period, there has been little research on its effectiveness in general and particularly in Ethiopia. The purpose of this study was to evaluate the effectiveness of LAM and the experiences of Ethiopian women who used it.
Methods
UNASSIGNED
This was a multi-center prospective cohort study of postpartum women from five Ethiopian regions and one city administration. All pregnant women who gave birth in these randomly selected hospitals and five health centers directly referring to the hospitals were invited to the study if they selected LAM and were followed monthly at home. Each month, trained researchers visited the woman at her home and collected information about breast feeding, the return of menses, the resumption of sex, the use of another contraceptive, and a pregnancy test using urine human chorionic gonadotropin (hCG). Women who reported starting new contraceptive methods, resumption of menses, starting complementary feeding, neonatal death, getting pregnant, or refusing were excluded from the cohort. The data were collected using ODK Collect and exported to Stata 14 for analysis.
Results
UNASSIGNED
Among the 2162 women who selected LAM as a contraceptive, 2022 were enrolled in the cohort study, and 901 completed the follow-up. At the end of the sixth month, eight women got pregnant, corresponding to an effectiveness of 99.1%. More than half of the cohort were excluded from the follow-up for reasons of transitioning to other types of contraception, resumption of menses, or refusal to follow-up.
Conclusion
UNASSIGNED
The effectiveness of LAM is high and should be recommended for postpartum women, with proper counseling provided. A study should be conducted to examine the effectiveness of breast feeding as a contraceptive beyond the Bellagio consensus.
Identifiants
pubmed: 37693930
doi: 10.2147/OAJC.S425574
pii: 425574
pmc: PMC10488729
doi:
Types de publication
Journal Article
Langues
eng
Pagination
149-157Informations de copyright
© 2023 Eticha et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
BMC Res Notes. 2018 Sep 3;11(1):641
pubmed: 30176910
Contraception. 2000 Nov;62(5):217-9
pubmed: 11172791
J Nurse Midwifery. 1996 Sep-Oct;41(5):405-6
pubmed: 8916683
Contraception. 1997 Jun;55(6):327-36
pubmed: 9262927
Contraception. 1989 Sep;40(3):365-76
pubmed: 2766725
Lancet. 1991 Mar 23;337(8743):715-7
pubmed: 1672186
Fertil Steril. 1995 Oct;64(4):717-23
pubmed: 7672141
BMC Res Notes. 2019 Jul 17;12(1):430
pubmed: 31315656
Cochrane Database Syst Rev. 2015 Oct 12;(10):CD001329
pubmed: 26457821
Contraception. 2000 Nov;62(5):221-30
pubmed: 11172792
Lancet. 2012 Jul 14;380(9837):149-56
pubmed: 22784533
Eur J Contracept Reprod Health Care. 2006 Dec;11(4):297-301
pubmed: 17484196
Lancet. 1992 Jan 25;339(8787):227-30
pubmed: 1346183
Contraception. 2004 Apr;69(4):317-22
pubmed: 15033407
Contraception. 1989 May;39(5):477-96
pubmed: 2656086