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New mothers are always strongly advised to look into birth control methods at their six-week postpartum checkup with the OBGYN.

There are many contraceptive options available these days, but postpartum women are in a unique position their body could provide built-in birth control that is just as effective as some of the more well known contraceptives! Read on to find out more about lactation amenorrhea. 

What is lactation amenorrhea?

Lactation amenorrhea is one demonstration of how well nature works. Having a baby very soon after another is a health risk for everyone involved the mother, the previous baby, and the new fetus. Breastfeeding, the natural and normal mode of infant nutrition, helps to prevent a situation in which a newly postpartum mother has to go through another pregnancy, right after having been through the whole process. In the modern world, in which there are many more birth control options than most women even know about, lactation amenorrhea isn't something we need to rely upon any more. But it is still something that happens, and that new mothers should know about. So, what exactly is lactation amenorrhea? Right after birth, women will experience lochia, a postpartum bleeding that can last up to six weeks and that will clear any pregnancy-related tissues out of the uterus which is also, incidentally, working to return to its normal non-pregnant size. Lochia is seen as a huge pain by many women. Who wants a "period" that lasts for six weeks? There is good news, however lochia may well be the last bleeding you see in a good while. After a woman has given birth and commenced breastfeeding, the hormone prolactin Gonadotropin Releasing Hormone (GnRH) is inhibited from the hypothalamus, therefore preventing all the important follow-up steps in a woman's reproductive system from occurring and preventing ovulation. When ovulation does not occur, there is no chance of pregnancy. Lactation amenorrhea simply said the lack of menstrual cycles and ovulation during the postpartum months is a phenomenon that naturally strikes women who exclusively breastfeed.

When does lactation amenorrhea work?

Mothers who have babies under six months old, who are exclusively breastfeeding (no formula, or water, or solids), and who have not had a period after their lochia stopped are very unlikely to get pregnant. Used consciously as a birth control method, lactation amenorrhea is 98 percent effective in the circumstances mentioned. That is as effective as many hormonal birth control methods. Lactation amenorrhea isn't supposed to be effective beyond six months, after a baby starts solid foods. Having said that, you'd want to monitor your body closely. Breastfeeding rates are appallingly low almost everywhere in the world, and not many women will still be breastfeeding beyond six months. I breastfed both my kids for extended periods of time. With the first, I didn't menstruate until 18 months postpartum. With the second, it took as long as 24 months to get my first postpartum period! It is highly possible that a woman will ovulate before her first period rears its head, so you'll want to look into an alternative birth control method at some point, unless you are open to having more children soon.

Lactation amenorrhea vs the birth control pill

Should you rely on lactation amenorrhea as your sole form of birth control during your postpartum period? There are some interesting as little known reasons in favor. Combined oral contraceptives better known as the birth control pill may not be suitable for breastfeeding women because:

  • They have a higher risk of developing venous thrombosis as a result of taking the pill, both because their hormonal cocktail is different and because they tend to be more physically inactive than the average woman. They are, after all, recovering from pregnancy and birth, and looking after a tiny baby.
  • Estrogen contained in the birth control pill passes into the breast milk and can decrease a woman's milk supply. Not something you want! Even if the effects of estrogen on a baby are not clear, you want to avoid any possible risk.
  • Combined hormonal contraceptives should absolutely not be used in women who are at less that 21 days postpartum. The World Health Organization recently updated their criteria to exclude these women, because of the risk of venous thrombosis. Later on, in the first 42 days, the WHO guidelines also strongly discourage the use of combined hormonal contraceptives.

Progestin-only pills are safer than combined hormonal contraceptives, so you may want to consider these. When in doubt, condoms are always a great temporary birth control option. They are both hormone free and very quickly reversible, after all!

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